Association of Glomerular Filtration Rate With Unsuccessful Primary Percutaneous Coronary Intervention and Subsequent Mortality in Patients With Acute Myocardial Infarction : From the HIJAMI Registry

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概要

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• Background Outcomes after percutaneous coronary intervention (PCI) for patients with acute myocardial infarction (AMI) complicated by renal insufficiency have not been well described. The aims of this study were to evaluate the association of estimated glomerular filtration rate (GFR) and risk of unsuccessful PCI for AMI, and to evaluate the prognostic importance of PCI success in patients with renal insufficiency. Methods and Results From the Heart Institute of Japan Acute Myocardial Infarction (HIJAMI) registry, 1,706 patients undergoing primary PCI were analyzed. The adjusted odds ratios for unsuccessful PCI of GFR 30-60 and <30ml・min^<-1>・1.73m^<-2> were 1.97 (95% confidence interval (CI): 1.22-3.18) and 2.56 (95%CI: 1.13-5.78), respectively. During the mean follow-up period of 29 months, the adjusted hazard ratios for death of successful compared with unsuccessful PCI were 1.0 (reference) compared with 2.04 (95%CI: 0.87-4.81) in the highest GFR group, 1.51 (95%CI: 1.11-2.06) compared with 2.07 (95%CI: 1.19-3.62) in the intermediate GFR group, and 2.69 (95%CI: 1.72-4.22) compared with 10.07 (95%CI: 4.91-20.5) in the lowest GFR group. Conclusions Decreased GFR was associated with the risk of unsuccessful primary PCI. Moreover, unsuccessful PCI was associated with strikingly poor long-term survival in patients with GFR <30ml・min^<-1>・1.73m^<-2>. Steady success is essential when using PCI for such a high-risk population.

• 社団法人日本循環器学会の論文
• 2008-01-20

著者

• Kasanuki Hiroshi

  Department of Cardiology, Tokyo Women's Medical University

• OGAWA Hiroshi

  Department of Pathology, Seirei Mikatahara General Hospital

• Ogawa Hiroshi

  Department Of Cardiology Tokyo Women's Medical University

• Ogawa Hisao

  Department Of Cardiology Tokyo Women's Medical University

• Yukio Tsurumi

  Tokyo Wemen's Medical University

• Tsurumi Yukio

  Department Of Cardiology And Radiology And Department Of Internal Medicine Tokyo Women's Medica

• Koganei Hiroshi

  Department of Cardiology, The heart Institute of Japan, Tokyo Women's Medical University

• Koganei Hiroshi

  Department Of Cardiology Tokyo Metroporitan Fuchu Hospital

• Ogawa Hiroshi

  Department Of Anatomy And Neurobiology Kyoto Prefectural University Of Medicine

• Kasanuki Hiroshi

  Toho Univ. Hosp.

• Ogawa Hisao

  Department Of Cardiology The Heart Institute Of Japan Tokyo Women's Medical University

• Koyanagi Hitoshi

  Department Of Cardiology Musashino Red Cross Hospital

• Kasanuki Hiroshi

  Departments Of Internal Medicine

• Tsurumi Yukio

  Department Of Cardiology Tokyo Women's Medical University

• Tsurumi Yukio

  Department Of Cardiology Kosei General Hospital

• Kasanuki Hiroshi

  Department Of Cardiovascular Surgery Heart Institute Tokyo Women's Medical University

• Hirosawa Koshichiro

  The Heart Institute Tokyo Women's Medical College

• Omori Hisako

  Department Of Cardiology Tokyo Womens Medical University

• Koyanagi Hitoshi

  Dept. Of Cardiovascular Surqery The Heart Institute Of Japan Tokyo Women's Medical College

• Kasanuki Hiroshi

  Department Of Cardiology The Heart Institute Of Japan

• Hirosawa Koushichiro

  Department Of Cardiology Heart Institute Of Japan Tokyo Women's Medical University

• Kasanuki Hiroshi

  Saga Prefectural Hospital Koseikan

• Ogawa Hisao

  Hijc Investigators

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