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Renal and cardiac function for long-term (10 year) risk stratification after myocardial infarction
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| 06.08.2009, 22:28 |
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Aims To determine whether combined renal and cardiac function after acute myocardial infarction (MI) predicts 10 year
mortality and heart failure (HF).
Methods
and results
Estimated glomerular filtration rate (eGFR), plasma amino terminal pro-brain natriuretic peptide (NT-proBNP), and
radionuclide ventriculography were obtained in 1063 patients with MI between 24–96 h of symptom onset. Mortality
and HF were documented over follow-up of 9.3 years. Estimated GFR, NT-proBNP, and left ventricular ejection fraction
(LVEF) each independently predicted 10 year mortality. Reduced eGFR (below 60 mL/min/1.73 m 2) combined
with increased NT-proBNP (above 1000 pg/mL) was associated with higher mortality rate compared with preserved
eGFR together with lower NT-proBNP (60 vs. 14%, P , 0.001). Similar results for mortality were identified for eGFR
combined with LVEF (dichotomized about 50%) (58 vs. 17%, P , 0.001). Corresponding analysis combining eGFR and
NT-proBNP to predict HF yielded rates of 34 and 7% for high- and low-risk groups, respectively ( P , 0.001). Similar
risk stratification for HF was observed when combining eGFR with LVEF (35 vs. 7%, P , 0.001).
Conclusion Ten year rates of mortality and HF are 5–10 times higher when lower eGFR is present together with increased NTproBNP
or depressed LVEF.
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Keywords Myocardial infarction † Kidney function † Mortality † Heart failure † Hospitalisation
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| Категория: Статьи | Добавил: nbylova
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