Research Paper|Volume 12, Issue 11|pp 10863—10872

Association between renal function impairment and multivessel involvement in patients with acute ST-elevation myocardial infarction

Rei-Yeuh Chang^1,^2,³, Han-Lin Tsai¹, Malcolm Koo^4,⁵, How-Ran Guo^6,⁷

¹Division of Cardiology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan
²Chung Jen Junior College of Nursing, Health Sciences and Management, Chiayi County, Taiwan
³Min-Hwei Junior College of Health Care Management, Tainan City, Taiwan
⁴Graduate Institute of Long-term Care, Tzu Chi University of Science and Technology, Hualien City, Taiwan
⁵Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
⁶Department of Environmental and Occupational Health, National Cheng Kung University, Tainan City, Taiwan
⁷Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan

Received: November 18, 2019Accepted: May 1, 2020Published: May 20, 2020

Copyright © 2020 Chang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The aim of this study was to evaluate the association between acute ST-elevation myocardial infarction (STEMI) involving multivessel and the severity of renal function impairment. We reviewed medical records of patients with acute STEMI admitted to a regional teaching hospital in southern Taiwan between March 1999 and October 2013. A total of 1215 patients who underwent coronary angiography were included. Multiple logistic regression analysis showed that multivessel involvement (at least two) with significant stenosis was significantly associated with stage 4 chronic kidney disease (adjusted odds ratio [aOR]=2.14, 95% confidence interval [CI]=1.09–4.20) and stage 5 chronic kidney disease (aOR=2.35, 95% CI=1.13–4.89), adjusting for age, sex, type 2 diabetes mellitus, hyperlipidemia, and systolic blood pressure at admission in patients with acute STEMI. In addition, multivessel total occlusion was significantly associated with stage 4 chronic kidney disease (aOR=3.68, 95% CI=1.27–10.70) and stage 5 chronic kidney disease (aOR=3.43, 95% CI=1.08–10.82), adjusting for heart rate at admission and systolic blood pressure at admission in patients with acute STEMI. In conclusion, severe renal function impairment was significantly associated with multivessel significant stenosis and multivessel total occlusion in patients with acute STEMI.