早期接受经皮冠脉介入治疗的不稳定性心绞痛/非ST段抬高性心肌梗死患者的肾功能和长期死亡率

作     者：Mueller C. Neumann F.-J. Perruchoud A.P. Buettner H.J. 艾文婷 

作者机构：Depar tment of Internal Medicine University Hospital Petersgraben 4 CH-4031 Basel SwitzerlandDr. 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2005年第1卷第1期

页      面：22-23页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：稳定性心绞痛 肾功能 冠状动脉造影 介入治疗 缺血心肌 肾小球滤过率 血供 前瞻性队列研究 定量研究 混杂因素 

摘      要：Objectives: To quantify the impact of baseline renal function on in-hospital and long term mortality in patients with unstable angina/non-ST elevation acute myocardial infarction (UA/NSTEMI) treated with a very early invasive strategy. Design: Prospective cohort study of 1400 consecutive patients with UA/NSTEMI und ergoing coronary angiography and subsequent coronary stenting of the culprit les ion as the primary revascularisation strategy within 24 hours of admission. Patients were stratified according to calculated glomerula r filtration rate (GFR) on admission. Results: In-hospital mortality was 0%amo ng patients with a GFR ≥130 ml/min/1.73 m2, 0.4%with a GFR of 90-129 ml/min/1 .73 m2, 2.6%with a GFR of 60-89 ml/min/1.73m2, and 5.1%with a GFR of 60 ml/ min/1.73 m2. Cumulative three year survival rates were 92.6%, 95.5%, 91.9%, a nd 76.8%, respectively. Patients with a GFR of 60 ml/min/1.73 m2 were four ti mes more likely to die in hospital (hazard ratio (HR) 4.0, 95%confidence interv al (CI) 1.8 to 9.1; p=0.001) and four times more likely to die during long term follow up (HR 4.0, 95%CI 2.5 to 6.4; p 0.001). After adjusting for potential c onfounders, a GFR of 60 ml/min/1.73 m2 remained a strong independent predictor of long term mortality (HR 2.6, 95%CI 1.5 to 4.5; p=0.001). Conclusions: Basel ine renal function is a strong independent predictor of in-hospital and long te rm mortality after UA/NSTEMI treated with very early revascularisa-tion.