Georgios C Lygouris, Vinay Mehta, Shuchita Gupta, Lynn D Morris and Vincent M Figueredo
Effect of Primary Percutaneous Coronary Intervention on Renal Function in Acute ST Elevation Myocardial Infarction
Objectives: Assess the effect of primary percutaneous coronary intervention (PCI) on renal function in the setting of acute ST elevation myocardial infarction (STEMI). Methods: Retrospective chart review of 270 STEMI patients that underwent primary PCI. Creatinine clearance was calculated using the re-expressed 4–variable Modification of Diet in Renal Disease (MDRD) formulas upon presentation to emergency room and prior to discharge from hospital or death. Results: Mean creatinine level upon presentation was 1.14 ± 0.43 mg/dl and upon discharge 1.07 ± 0.51 mg/dl (p=0.013). Mean CrCl on admission was 77 ± 27 ml/min/1.73m2 and improved to 86 ± 31 ml/min/1.73m2 upon discharge (p<0.001). This improvement was observed in patients with all stages of chronic kidney disease (CKD), including stage III (47 ± 9 vs 55 ± 18 ml/min/1.73m2, p=0.001) and stage IV (24 ± 4 vs 29 ± 10 ml/min/1.73m2; p=0.13). Statistically significant improvement in CrCl (79 ± 28 vs. 86 ± 31 ml/min/1.73m2, p < 0.001) was observed in African American patients (72% of study group). Conclusion: In STEMI patients, primary PCI does not appear to be associated with worsening, but rather an improvement, in renal function upon hospital discharge.
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