Renal insufficiency was correlated with 2-year mortality for rural female patients with ST-segment elevation acute myocardial infarction after reperfusion therapy: A multicenter, prospective study

Abstract

Background: Renal insufficiency (RI) following ST-segment elevation acute myocardial infarction (STEMI) is associated with a worse clinical prognosis. We investigated the impact of RI on long-term mortality in rural female patients with STEMI and evaluated prognostic factors. Methods: A prospective cohort study of 436 consecutive rural female patients who were successfully treated with reperfusion therapy for STEMI between May 2009 and August 2011 in secondary care hospitals in Liaoning province northeastern China and followed up for 2years. Patients were divided into three groups by estimated glomerular filtration rate (eGFR): Normal group, eGFR ≥90mL/min/1.73m2 (n = 233). Moderate group, eGFR 60-90mL/min/1.73m2 (n = 108). RI group, eGFR <60mL/min/1.73m2 (n = 95). The primary outcome was 2-year mortality. Results: During follow-up (mean 741 ± 118days), the RI group had a significantly higher mortality than the other groups (24.21% vs. 6.87% and 10.19%, p < 0.001). The RI group had significantly higher hospital mortality (7.37% p = 0.045 vs. Normal group). RI increased the risk of hospital mortality (hazard ratio (HR) 1.832, 95% CI 1.017-3.091, p = 0.033), and increased the risk of 2-year mortality (HR 3.872, 95% CI 2.004-6.131, p < 0.001). Multivariate analysis showed eGFR <90ml/min/1.73m2 and age ≥75years as independent predictors of mortality at 2years. In detail these were eGFR 60-90ml/min/1.73m2 with HR 2.081, 95%CI 1.250-2.842, p < 0.001; eGFR <60ml/min/1.73m2 with HR 3.872, 95%CI 2.004-6.131, p < 0.001; age ≥75 with HR 1.461, 95%CI 1.011-1.952, p = 0.024. Conclusions: RI had a powerful correlation with long-term mortality for rural female patients with STEMI after reperfusion therapy.