Association between renal function and adverse outcomes in patients with st-elevation myocardial infarction

Renal dysfunction has been associated with adverse cardiovascular outcomes. Glomerular filtration rate (GFR) is a critical indicator of renal function.This study aims to evaluate the association between GFR and complications in patients with ST-elevation myocardial infarction(STEMI), including atrial fibrillation (AF), high degree atrioventricular (AV) block, in-hospital pneumonia, acute renal failure (ARF), and mortality.

This is a prospective, observational, single-center study. A total of 940 STEMI patients were included. All patients underwent primary percutaneous coronary intervention and received standard pharmacological treatment for STEMI following current guidelines. We conducted a logistic regression analysis on STEMI patients to assess the impact of GFR on the incidence of several complications. GFR was used as an independent predictor variable, while each complication was modeled individually as a dependent binary outcome. Odds ratios (OR), coefficients, and p-values were calculated to estimate the strength and significance of associations between GFR and each complication.

Lower GFR was significantly associated with increased odds of complications such as AF (OR = 0.982, p = 0.011), high degree AV block (OR = 0.967, p < 0.001), in-hospital pneumonia (OR = 0.978, p < 0.001), and ARF (OR = 0.931, p = 0.034). These findings suggest that each unit decrease in GFR corresponds with a slight but statistically significant increase in the likelihood of these complications. Additionally, while the odds ratio for in-hospital death (OR = 0.977, p = 0.071) did not reach statistical significance, it demonstrated a potential trend towards increased mortality risk with lower GFR.

GFR is an important predictor of several complications in STEMI patients. These results underscore the importance of assessing renal function in STEMI patients for early identification of high-risk patients. Further research is warranted to explore the underlying mechanisms and to validate these findings in larger cohorts.