Effect of the glomerular filtration rate before emergency PCI on the prognosis of patients with ST-segment elevation myocardial infarction

Objective: To investigate the effects of the glomerular filtration rate(eGRF) before emergency percutaneous coronary intervention(PCI) on the prognosis of patients with ST-segment elevation myocardial infarction(STEMI).Methods: One hundred and thirty-four STEMI patients treated with PCI were divided into the low eGFR group(14cases,eGFR<60 mL·min^-1·1.73 m^-2) and high eGFR group(120 cases,eGFR>60 mL·min^-1·1.73 m^-2) according to the preoperative level of eGFR.The MIRI and incidence rate of MACE between two groups were compared.Results: The age,previous incidence of stroke,ratio of patients with Killip ≥ Ⅲ grade,levels of hs-CRP and BNP,and gensini score in low eGFR group were higher than those in high eGFR group(P<0.05 to P<0.01).The LVEF level in low eGFR group was significantly lower than that in high eGFR group(P<0.01).Compared with the high eGFR group,the incidence rates of death,restenosis and acute heart failure during hospitalization were higher in low eGFR group(P<0.01),and the differences of the incidence rates of myocardial infarction,stroke,cardiogenic death and vascular reconstruction between two groups after 1 year of PCI were not statistically significant(P<0.05).Multiple logistic regression analysis results showed that the Killip ≥ Ⅲ grade and eGFR<60 mL·min^-1·1.73 m^-2 was the independent risk factor for in-hospital mortality in patients with STEMI.Conclusions: The incidence rate of in-hospital MACE in STEMI patients with low eGFR is high,and also the independent risk factor for in-hospital mortality in patients with STEMI.Monitoring the level of eGFR and adjusting medicine can actively improve kidney function of patients.