Impact of Baseline Estimated Glomerular Filtration Rate Using Ckd-Epi Equation on Long-Term Prognosis of Stemi Patients: A Matter of Small Increments! Publisher Pubmed



Sadrebafghi SA¹ ; Mohebi M² ; Hadi F³ ; Parsaiyan H² ; Memarjafari M² ; Tayeb R² ; Ghodsi S⁴ ; Sheikhsharbafan R² ; Poorhosseini H⁵ ; Salarifar M⁵ ; Alidoosti M⁵ ; Hajizeinali AM⁵ ; Amirzadegan A⁵ ; Aghajani H⁵ Show All Authors Show Affiliations
Source: Critical Pathways in Cardiology Published:2022

Abstract

Background: Baseline biomarkers including glomerular filtration rate (GFR) guide the management of patients with ST-segment elevation myocardial infarction (STEMI). GFR is a tool for prediction of adverse outcomes in these patients. Objectives: We aimed to determine the prognostic utility of estimated GFR using Chronic Kidney Disease Epidemiology Collaboration in a cohort of STEMI patients. Methods: A retrospective cohort was designed among 5953 patients with STEMI. Primary endpoint of the study was major adverse cardiovascular events. GFR was classified into 3 categories delineated as C1 (<60 mL/min), C2 (60-90), and C3 (≥ 90). Results: Mean age of the patients was 60.38 ± 5.54 years and men constituted 78.8% of the study participants. After a median of 22 months, Multivariate Cox-regression demonstrated that hazards of major averse cardiovascular event, all-cause mortality, cardiovascular mortality, and nonfatal myocardial infarction were significantly lower for subjects in C3 as compared with those in C1. Corresponding hazard ratios (HRs) for mentioned outcomes regarding C3 versus C1 were (95% confidence interval) were (HR = 0.852 [0.656-0.975]; P = 0.035), (HR = 0.425 [0.250-0.725]; P = 0.002), (HR = 0.425 [0.242-0.749]; P = 0.003), and (0.885 [0.742-0.949]; P = 0.003), respectively. Normal GFR was also associated with declined in-hospital mortality with HR of C3 versus C1: 0.299 (0.178-0.504; P < 0.0001). Conclusions: Baseline GFR via Chronic Kidney Disease Epidemiology Collaboration is associated with long-term cardiovascular outcomes following STEMI. © 2022 Lippincott Williams and Wilkins. All rights reserved.