In Turkish Geriatric Patients with Myocardial Infarction Undergoing Primary PCI Risk Factors Determining in-Hospital Mortality and The Relationship Between Kidney Function

Year 2023, Volume: 2 Issue: 1, 16 - 21, 30.03.2023

Ömer Şatıroğlu , Muharrem Kara

Abstract

Geriatric population (>80 years) has an increased mortality risk due to several reasons including more extensive coronary artery disease (CAD) and impaired renal function. We investigated the relationship between in-hospital mortality and renal dysfunction in geriatric patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous intervention (PCI). We included 203 geriatric patients with STEMI who underwent primary PCI. Patients were divided into 2 groups; group 1 comprised 42 patients who died in the hospital after MI, and group 2 included 161 patients who were discharged following primary PCI. The risk factors of the patients were determined. We calculated coronary artery disease prevalence by Gensini risk score, renal function by creatinine clearance (CrCl), and compared 2 groups. The patients in group 1 who died in hospital after STEMI were older; they had more extensive CAD and lower CrCl (age: 82 ± 5 yr, 78 ± 7 yr, p<0.001; Gensini score: 70 ± 30, 42 ± 26, p: 0.001; CrCl: 46 ± 17 mL/min, 65 ± 18 mL/min, p<0.001). When multivariate analysis was performed with logistic regression, we found to be CrCl, HDL-cholesterol, and Gensini scores to be the independent predictors of in-hospital mortality (CCL: OR 1.057 (1.029-1.086), p = 0.001); HDL: OR 1.077 (1.021-1.136), p = 0.007, Gensini score: OR 0.969 (0.952-0.985), p = 0.001). Renal dysfunction increases in-hospital mortality in elderly patients with STEMI undergoing primary PCI. Renal dysfunction in elderly patients with MI is an important risk factor that increases in-hospital mortality like other cardiovascular risk factors.

Keywords

Geriatric population, ST elevation myocardial infarction, renal function, creatinine clearance, Gensini score.

Project Number

yok

Primer Perkütan Koroner Girişim Yapılan Miyokard İnfarktüslü Türk Geriatrik Hastalarda Hastane İçi Mortalitesini Belirleyen Risk Faktörleri ve Böbrek Fonksiyonu Arasındaki İlişki

Abstract

Geriatrik popülasyon (>80 yaş), daha yaygın koroner arter hastalığı (KAH) ve bozulmuş böbrek fonksiyonu gibi çeşitli nedenlerden dolayı artmış mortalite riskine sahiptir. Primer perkütan girişim (PCI) uygulanan ST yükselmeli miyokard enfarktüsü (STEMI) olan geriatrik hastalarda hastane içi mortalite ile böbrek fonksiyon bozukluğu arasındaki ilişkiyi araştırdık. Primer PCI uygulanan STEMI'li 203 geriatrik hastayı dahil ettik. Hastalar 2 gruba ayrıldı; grup 1, Miyokard infarktüsü (MI) sonrası hastanede ölen 42 hastadan, grup 2 ise primer PKG sonrası taburcu edilen 161 hastadan oluşuyordu. Hastaların risk faktörleri belirlendi. Koroner arter hastalığı prevalansını Gensini risk skoru ile, renal fonksiyonu kreatinin klirensi (CrCl) ile hesapladık ve 2 grubu karşılaştırdık. Grup 1'de STEMI sonrası hastanede ölen hastalar daha yaşlıydı; daha yaygın KAH ve daha düşük CrCl'ye sahiptiler (yaş: 82 ± 5 yıl, 78 ± 7 yıl, p<0.001; Gensini skoru: 70 ± 30, 42 ± 26, p: 0.001; CrCl: 46 ± 17 mL/dk, 65 ± 18 mL/dak, p<0.001). Lojistik regresyon ile çok değişkenli analiz yapıldığında CrCl, HDL-kolesterol ve Gensini skorlarının hastane içi mortalitenin bağımsız öngördürücüleri olduğunu bulduk (CCL: OR 1.057 (1.029-1.086), p = 0.001); HDL: OR 1.077 (1.021-1.136), p = 0.007, Gensini skoru: OR 0.969 (0.952-0.985), p = 0.001). Primer PKG uygulanan STEMI'li yaşlı hastalarda renal disfonksiyon hastane içi mortaliteyi artırmaktadır. MI'lı yaşlı hastalarda böbrek fonksiyon bozukluğu, diğer kardiyovasküler risk faktörleri gibi hastane içi mortaliteyi artıran önemli bir risk faktörüdür.

Keywords

Geriatrik popülasyon, ST yükselmeli miyokard infarktüsü, böbrek fonksiyonu, kreatinin klirensi, Gensini skoru.

Supporting Institution

yok

Project Number

yok

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