International Heart Journal
Online ISSN : 1349-3299
Print ISSN : 1349-2365
ISSN-L : 1349-2365
Clinical Studies
Prognostic Impact of Chronic Kidney Disease and Anemia at Admission on In-Hospital Outcomes After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction
Jun ShiraishiYoshio KohnoTakeshi NakamuraTakashi YanagiuchiSho HashimotoDaisuke ItoMasayoshi KimuraAkihiro MatsuiHirokazu YokoiMasayasu AriharaMasayuki HyogoTakatomo ShimaTakahisa SawadaSatoaki MatobaHiroyuki YamadaAkiyoshi MatsumuroTakeshi ShirayamaMakoto KitamuraKeizo Furukawaon Behalf of the AMI-Kyoto Multi-Center Risk Study Group
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2014 Volume 55 Issue 4 Pages 301-306

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Abstract

Cardiorenal anemia syndrome has recently been receiving greater attention; however, data regarding the relationship between chronic kidney disease (CKD)/anemia on presentation and in-hospital outcome in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) are still limited in Japan.
A total of 1,447 primary PCI-treated AMI patients were classified into 4 groups according to the presence of CKD and/or anemia on hospital admission (with CKD/with anemia n = 222, with CKD/without anemia n = 299, without CKD/with anemia n = 151, without CKD/without anemia n = 775). Angiographic acute results of primary PCI were similar among the 4 groups. The patients with CKD had a significantly higher in-hospital overall mortality rate than the patients without CKD, and in the presence or absence of CKD, patients with anemia tended to have a higher in-hospital mortality rate than the patients without anemia. According to a multivariate analysis, anemia on admission was found to be an independent predictor of in-hospital mortality, whereas admission CKD and admission eGFR were statistically not independent predictors. Moreover, the multivariable adjusted odds ratio of in-hospital death in AMI patients with CKD alone was 1.855 (95% CI 0.929-3.706), and that in AMI patients with CKD/with anemia was 3.384 (95% CI 1.697-6.748).
These results suggest that among real-world, unselected Japanese AMI patients undergoing primary PCI, the combination of CKD and anemia on admission confers significant adverse effects on in-hospital mortality.

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© 2014 by the International Heart Journal Association
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