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Relation between re...
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Szummer, KarolinaKarolinska Institutet,Huddinge, Sweden
(author)
Relation between renal function, presentation, use of therapies and in-hospital complications in acute coronary syndrome : data from the SWEDEHEART register
- Article/chapterEnglish2010
Publisher, publication year, extent ...
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Wiley,2010
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Numbers
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LIBRIS-ID:oai:DiVA.org:uu-122599
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-122599URI
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https://doi.org/10.1111/j.1365-2796.2009.02204.xDOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:120598924URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-58369URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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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.
Subject headings and genre
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in-hospital
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kidney
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myocardial infarction
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prognosis
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therapies
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MEDICINE
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MEDICIN
Added entries (persons, corporate bodies, meetings, titles ...)
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Lundman, P.Karolinska Institutet,Danderyd Hospital
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Jacobson, S. H.Karolinska Institutet,Danderyd Hospital,Ryhov County Hospital
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Schön, Staffan
(author)
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Lindbäck, JohanUppsala universitet,Uppsala kliniska forskningscentrum (UCR),Uppsala University Hospital(Swepub:uu)jolin255
(author)
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Stenestrand, UlfÖstergötlands Läns Landsting,Linköpings universitet,Kardiologi,Hälsouniversitetet,Kardiologiska kliniken(Swepub:liu)ulfst38
(author)
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Wallentin, Lars,1943-Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR),Uppsala University Hospital(Swepub:uu)larswall
(author)
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Jernberg, T.Karolinska Institutet,Huddinge, Sweden
(author)
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Karolinska InstitutetHuddinge, Sweden
(creator_code:org_t)
Related titles
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In:Journal of Internal Medicine: Wiley268:1, s. 40-490954-68201365-2796
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