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Relation between re...
Relation between renal function, presentation, use of therapies and in-hospital complications in acute coronary syndrome : data from the SWEDEHEART register
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- Szummer, Karolina (författare)
- Karolinska Institutet,Huddinge, Sweden
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- Lundman, P. (författare)
- Karolinska Institutet,Danderyd Hospital
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- Jacobson, S. H. (författare)
- Karolinska Institutet,Danderyd Hospital,Ryhov County Hospital
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Schön, Staffan (författare)
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- Lindbäck, Johan (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Uppsala University Hospital
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- Stenestrand, Ulf (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Kardiologi,Hälsouniversitetet,Kardiologiska kliniken
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- Wallentin, Lars, 1943- (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR),Uppsala University Hospital
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- Jernberg, T. (författare)
- Karolinska Institutet,Huddinge, Sweden
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(creator_code:org_t)
- Wiley, 2010
- 2010
- Engelska.
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 268:1, s. 40-49
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Abstract
Ämnesord
Stäng
- Abstract. Szummer K, Lundman P, Jacobson SH, Schön S, Lindbäck J, Stenestrand U, Wallentin L, Jernberg T, for SWEDEHEART. (Karolinska Institute, Karolinska University Hospital, Stockholm; Karolinska Institute, Danderyd Hospital, Danderyd; Ryhov County Hospital, Jönköping; University Hospital, Uppsala and University Hospital, Linköping; Sweden) Relation between renal function, presentation, use of therapies and in-hospital complications in acute coronary syndrome: data from the SWEDEHEART register. J Intern Med 2009; doi: 10.1111/j.1365-2796.2009.02204.x. Objective. To examine clinical characteristics, presenting symptoms, use of therapy and in-hospital complications in relation to renal function in patients with myocardial infarction (MI). Design. Observational study. Setting. Nationwide coronary care unit registry between 2003-2006 in Sweden. Subjects. Consecutive MI patients with available creatinine (n = 57 477). Results. Glomerular filtration rate was estimated with the Modification of Diet in Renal Disease Study formula. With declining renal function patients were older, had more co-morbidities and more often used cardio-protective medication on admission. Compared to patients with normal renal function, fewer with renal failure presented with chest pain (90% vs. 67%, P < 0.001), Killip I (89% vs. 58%, P < 0.001) and ST-elevation myocardial infarction (STEMI) (41% vs. 22%, P < 0.001). In a logistic regression model lower renal function was independently associated with a less frequent use of anticoagulant and revascularization in non-ST-elevation MI. The likelihood of receiving reperfusion therapy for STEMI was similar in patients with normal-to-moderate renal dysfunction, but decreased in severe renal dysfunction or renal failure. Reperfusion therapy shifted from primary percutaneous coronary intervention in 71% of patients with normal renal function to fibrinolysis in 58% of those with renal failure. Renal function was associated with a higher rate of complications and an exponential increase in in-hospital mortality from 2.5% to 24.2% across the renal function groups. Conclusion. Renal insufficiency influences the presentation and reduces the likelihood of receiving treatment according to current guidelines. Short-term prognosis remains poor.
Nyckelord
- in-hospital
- kidney
- myocardial infarction
- prognosis
- therapies
- MEDICINE
- MEDICIN
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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