Objective: To evaluate the clinical features of non-ST-segment-elevation myocardial infarction (NSTEMI) patients with renal dysfunction and investigate correlation factor for in-hospital death and 6 months adverse events of NSTEMI patients.
Methods: One hundred and sixteen patients presenting with NSTEMI were enrolled between January 2006 and September 2007. Estimation of glomerular filtrate rate (eGFR) was conducted by the modified abbreviated MDRD equations based on the Chinese CKD patients. Renal dysfunction was defined as eGFR < 60 mL/(min.1.73 m2) and/or as having the other evidence of chronic kidney damage over 3 months or more. All the clinical data were collected. Correlation factors of in-hospital death and 6-month adverse events were evaluated.
Results: 29.3 percentage of patients presented with renal dysfunction (34/116), patients with renal dysfunction were older, more likely to have history of hypertension, diabetes mellitus and angina compared with those with normal renal function, and more likely to be with heart function killip grades III-IV, higher level of the plasma fibrinogen on admission, lower left ventricular ejection. Patients with renal dysfunction experienced less angiography, more coronary artery calcification, and less percutaneous coronary interventional treatment. Multifactorial logistic regression analysis showed that killip grades III-IV on admission (OR = 13.12, P = 0.000) were independently correlated with the in hospital death, killip grades III-IV on admission (OR = 6.265, P = 0.002) and renal dysfunction (OR = 3.545, P = 0.007) might be independent risk factors of 6-month adverse events in patients with NSTEMI.
Conclusion: Patients with renal dysfunction were older, more likely to have history of hypertension, diabetes mellitus and angina, and more likely to be with heart function killip grades III-IV, more coronary artery calcification; killip grades III-IV on admission were independently correlated with the in-hospital death; killip grades III-IV on admission and renal dysfunction might be independent risk factors of 6-month adverse events in patients with NSTEMI.