J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 8, Number 4, April 2016, pages 325-330

The Impact of Admission Serum Creatinine Derived Estimated Glomerular Filtration Rate on Major Adverse Cardiac Events in ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

**Table 1.** Demographics of All Patients by Estimated Glomerular Filtration Rate
Demographics	Estimated glomerular filtration rates (mL/min/1.73 m²)	P
Variables are reported as mean ± standard deviation or counts (percentages). F/M: female/male; CAD: coronary artery disease; eGFR: estimated glomerular filtration rate; CK-MB: creatine kinase-myocardial band.
Patient no., n (%)	72 (8.1)	390 (44.1)	345 (39)	77 (8.7)
Gender (F/M), n	20/52	53/337	30/315	8/69	< 0.001
Age, years	59 ± 8.9	55.8 ± 8.3	51.1 ± 9	50.2 ± 8.5	< 0.001
Smoking, n (%)	38 (52.7)	238 (61.1)	211 (60.3)	57 (74)	0.118
CAD, n (%)	9 (12.5)	80 (20.5)	56 (16.2)	14 (18.2)	0.262
Diabetes mellitus, n (%)	30 (41)	113 (29)	66 (19)	19 (24.6)	0.137
Hypertension, n (%)	49 (68)	169 (43.3)	103 (29.8)	23 (29%)	0.072
Follow-up, months	18.9 ± 16	21.8 ± 15.6	22.8 ± 14.1	22.1 ± 13	0.245
Hospitalization, days	9.2 ± 5.3	7.8 ± 4.4	7.1 ± 3.8	7.7 ± 4.6	0.004
eGFR	50.5 ± 9.2	76.7 ± 7.3	101.3 ± 8	134 ± 12.2	< 0.001
Admission creatine, mg/dL	1.4 ± 0.4	1.03 ± 0.1	0.83 ± 0.07	0.67 ± 0.05	< 0.001
CK-MB, U/L	310 ± 215	216 ± 182	231 ± 177	225 ± 186	< 0.001
Leucocyte, 10³/µL	14.5 ± 4.7	13 ± 4	12.7 ± 3.4	12.6 ± 3.1	0.004
Hemoglobin, mg/dL	13.9 ±1.3	14.2 ± 1.3	14.1 ± 1.1	14.2 ± 0.9	0.625
Admission glucose, mg/dL	203 ± 104	161 ± 75	147 ± 64	157 ± 88	< 0.001
Potassium	4.4 ± 0.6	4.1 ± 0.5	4.1 ± 0.47	4.05 ± 0.49	< 0.001
Stent diameter, mm	3.1 ± 0.37	3.13 ± 0.36	3.15 ± 0.32	3.06 ± 0.34	0.277
Stent length, cm	21.4 ± 9	19.5 ± 6.8	18.5 ± 6.2	20.4 ± 5.8	0.013
Ejection fraction, %	42.2 ± 12	48.2 ± 10.2	49.2 ± 10.1	51.1 ± 8.8	< 0.001

Table 1. Demographics of All Patients by Estimated Glomerular Filtration Rate

Demographics

Estimated glomerular filtration rates (mL/min/1.73 m²)

< 60

≥ 60 - < 90

≥ 90 - 120

≥ 120

Variables are reported as mean ± standard deviation or counts (percentages). F/M: female/male; CAD: coronary artery disease; eGFR: estimated glomerular filtration rate; CK-MB: creatine kinase-myocardial band.

Patient no., n (%)

72 (8.1)

390 (44.1)

345 (39)

77 (8.7)

Gender (F/M), n

20/52

53/337

30/315

8/69

< 0.001

Age, years

59 ± 8.9

55.8 ± 8.3

51.1 ± 9

50.2 ± 8.5

< 0.001

Smoking, n (%)

38 (52.7)

238 (61.1)

211 (60.3)

57 (74)

0.118

CAD, n (%)

9 (12.5)

80 (20.5)

56 (16.2)

14 (18.2)

0.262

Diabetes mellitus, n (%)

30 (41)

113 (29)

66 (19)

19 (24.6)

0.137

Hypertension, n (%)

49 (68)

169 (43.3)

103 (29.8)

23 (29%)

0.072

Follow-up, months

18.9 ± 16

21.8 ± 15.6

22.8 ± 14.1

22.1 ± 13

0.245

Hospitalization, days

9.2 ± 5.3

7.8 ± 4.4

7.1 ± 3.8

7.7 ± 4.6

0.004

eGFR

50.5 ± 9.2

76.7 ± 7.3

101.3 ± 8

134 ± 12.2

< 0.001

Admission creatine, mg/dL

1.4 ± 0.4

1.03 ± 0.1

0.83 ± 0.07

0.67 ± 0.05

< 0.001

CK-MB, U/L

310 ± 215

216 ± 182

231 ± 177

225 ± 186

< 0.001

Leucocyte, 10³/µL

14.5 ± 4.7

13 ± 4

12.7 ± 3.4

12.6 ± 3.1

0.004

Hemoglobin, mg/dL

13.9 ±1.3

14.2 ± 1.3

14.1 ± 1.1

14.2 ± 0.9

0.625

Admission glucose, mg/dL

203 ± 104

161 ± 75

147 ± 64

157 ± 88

< 0.001

Potassium

4.4 ± 0.6

4.1 ± 0.5

4.1 ± 0.47

4.05 ± 0.49

< 0.001

Stent diameter, mm

3.1 ± 0.37

3.13 ± 0.36

3.15 ± 0.32

3.06 ± 0.34

0.277

Stent length, cm

21.4 ± 9

19.5 ± 6.8

18.5 ± 6.2

20.4 ± 5.8

0.013

Ejection fraction, %

42.2 ± 12

48.2 ± 10.2

49.2 ± 10.1

51.1 ± 8.8

< 0.001

**Table 2.** In-Hospital and Long-Term Events of All Patients by Glomerular Filtration Rate
	Estimated glomerular filtration rates (mL/min/1.73 m²)	P
Variables are reported as mean ± standard deviation or counts (percentages). Major adverse cardiac events included mortality, re-infarction and target vessel revascularization. TVR: target vessel revascularization; MACE: major adverse cardiac event; CPR: cardiopulmonary resuscitation; VT-VF: ventricular tachycardia-ventricular fibrillation; CHD: congestive heart disease; IABP: intra-aortic balloon pump; GIS: gastrointestinal system.
Shock, n (%)	8 (11.3)	13 (3.4)	4 (1.2)	-	< 0.001
Killip class > 1, n (%)	19 (34.5)	30 (11.1)	13 (5.1)	3 (5.5)	< 0.001
In-hospital mortality, n (%)	9 (12.5)	5 (1.3)	1 (0.3)	-	< 0.001
Re-infarction, n (%)	3 (4.2)	6 (1.5)	7 (2)	3 (3.9)	0.358
TVR, n (%)	5 (6.9)	19 (4.9)	12 (3.5)	5 (6.5)	0.464
MACE, n (%)	12 (16.7)	23 (5.9)	13 (3.8)	5 (6.5)	0.001
Stroke, n (%)	3 (4.2)	3 (0.8)	1 (0.3)	-	0.007
CPR, n (%)	10 (13.9)	9 (2.3)	5 (1.4)	-	< 0.001
Dialysis, n (%)	3 (4.2)	-	-	-	< 0.001
VT-VF, n (%)	9 (12.5)	15 (3.8)	14 (4.1)	3 (3.9)	0.012
CHD, n (%)	29 (40.3)	64 (16.4)	43 (12.5)	9 (11.7)	< 0.001
Inotrop usage, n (%)	19 (26.4)	37 (9.5)	29 (8.4)	2 (2.6)	< 0.001
IABP usage, n (%)	10 (13.9)	15 (3.8)	9 (2.6)	1 (1.3)	< 0.001
Atrial Fibrillation, n (%)	6 (8.3)	5 (1.3)	4 (1.2)	1 (1.3)	< 0.001
GIS bleeding, n (%)	1 (1.4)	2 (0.5)	2 (0.6)	-	0.723
Inguinal complication, n (%)	3 (4.2)	17 (4.4)	14 (4.1)	1 (1.3)	0.656
Thrombus (0 - 1 day), n (%)	1 (1.4)	1 (0.3)	3 (0.9)	1 (1.3)	0.533
Thrombus (1 - 30 days), n (%)	3 (4.2)	9 (2.3)	7 (2)	5 (6.5)	0.133
Thrombus (> 30 days), n (%)	3 (4.2)	8 (2.1)	8 (2.3)	-	0.369
Transfusion, n (%)	3 (4.2)	11 (2.8)	4 (1.2)	3 (3.9)	0.233
Cardiac death on follow-up, n (%)	6 (9.5)	12 (3.1)	11 (3.3)	1 (1.3)	0.046
CHD/Shock on follow-up, n (%)	13 (22.8)	38 (11.1)	25 (8.1)	5 (7.4)	0.008
Stroke on follow-up, n (%)	-	8 (2.4)	-	-	0.017
Re-infarction on follow-up, n (%)	10 (18.2)	28 (8.3)	21 (6.8)	9 (13.2)	0.026
TVR on follow-up, n (%)	18 (32.1)	76 (22.4)	63 (20.3)	17 (25)	0.247
MACE on follow-up, n (%)	24 (41.4)	95 (27.5)	71 (22.8)	20 (29.4)	0.028

Table 2. In-Hospital and Long-Term Events of All Patients by Glomerular Filtration Rate

Estimated glomerular filtration rates (mL/min/1.73 m²)

< 60

≥ 60 - < 90

≥ 90 - 120

≥ 120

Variables are reported as mean ± standard deviation or counts (percentages). Major adverse cardiac events included mortality, re-infarction and target vessel revascularization. TVR: target vessel revascularization; MACE: major adverse cardiac event; CPR: cardiopulmonary resuscitation; VT-VF: ventricular tachycardia-ventricular fibrillation; CHD: congestive heart disease; IABP: intra-aortic balloon pump; GIS: gastrointestinal system.

Shock, n (%)

8 (11.3)

13 (3.4)

4 (1.2)

< 0.001

Killip class > 1, n (%)

19 (34.5)

30 (11.1)

13 (5.1)

3 (5.5)

< 0.001

In-hospital mortality, n (%)

9 (12.5)

5 (1.3)

1 (0.3)

< 0.001

Re-infarction, n (%)

3 (4.2)

6 (1.5)

7 (2)

3 (3.9)

0.358

TVR, n (%)

5 (6.9)

19 (4.9)

12 (3.5)

5 (6.5)

0.464

MACE, n (%)

12 (16.7)

23 (5.9)

13 (3.8)

5 (6.5)

0.001

Stroke, n (%)

3 (4.2)

3 (0.8)

1 (0.3)

0.007

CPR, n (%)

10 (13.9)

9 (2.3)

5 (1.4)

< 0.001

Dialysis, n (%)

3 (4.2)

< 0.001

VT-VF, n (%)

9 (12.5)

15 (3.8)

14 (4.1)

3 (3.9)

0.012

CHD, n (%)

29 (40.3)

64 (16.4)

43 (12.5)

9 (11.7)

< 0.001

Inotrop usage, n (%)

19 (26.4)

37 (9.5)

29 (8.4)

2 (2.6)

< 0.001

IABP usage, n (%)

10 (13.9)

15 (3.8)

9 (2.6)

1 (1.3)

< 0.001

Atrial Fibrillation, n (%)

6 (8.3)

5 (1.3)

4 (1.2)

1 (1.3)

< 0.001

GIS bleeding, n (%)

1 (1.4)

2 (0.5)

2 (0.6)

0.723

Inguinal complication, n (%)

3 (4.2)

17 (4.4)

14 (4.1)

1 (1.3)

0.656

Thrombus (0 - 1 day), n (%)

1 (1.4)

1 (0.3)

3 (0.9)

1 (1.3)

0.533

Thrombus (1 - 30 days), n (%)

3 (4.2)

9 (2.3)

7 (2)

5 (6.5)

0.133

Thrombus (> 30 days), n (%)

3 (4.2)

8 (2.1)

8 (2.3)

0.369

Transfusion, n (%)

3 (4.2)

11 (2.8)

4 (1.2)

3 (3.9)

0.233

Cardiac death on follow-up, n (%)

6 (9.5)

12 (3.1)

11 (3.3)

1 (1.3)

0.046

CHD/Shock on follow-up, n (%)

13 (22.8)

38 (11.1)

25 (8.1)

5 (7.4)

0.008

Stroke on follow-up, n (%)

8 (2.4)

0.017

Re-infarction on follow-up, n (%)

10 (18.2)

28 (8.3)

21 (6.8)

9 (13.2)

0.026

TVR on follow-up, n (%)

18 (32.1)

76 (22.4)

63 (20.3)

17 (25)

0.247

MACE on follow-up, n (%)

24 (41.4)

95 (27.5)

71 (22.8)

20 (29.4)

0.028

**Table 3.** Logistic Regression Models for In-Hospital Mortality by Estimated Glomerular Filtration Rate
Mortality	Estimated glomerular filtration rates (mL/min/1.73 m²)
All data are presented as odds ratio (95% confidence interval). Logistic models: model 1: unadjusted model; model 2: adjusted model for age and sex; model 3: adjusted model for age, sex and past medical history; model 4: adjusted model for all covariates including age, gender, history, duration of hospitalization, left ventricular ejection fraction, CK-MB, potassium, diameter and length of the stent.
Model 1	7.78 (0.91 - 66.8)	2.41 (0.31 - 18.7)	2.49 (0.32 - 19.6)	1 (Reference)
Model 2	4.57 (0.5 - 41.1)	1.74 (0.21 - 13.9)	2.37 (0.29 - 18.7)	1 (Reference)
Model 3	4.3 (0.46 - 39.6)	1.81 (0.22 - 14.5)	2.49 (0.31 - 19.8)	1 (Reference)
Model 4	2.92 (0.23 - 36.8)	1.16 (0.12 - 10.8)	1.37 (0.14 - 12.7)	1 (Reference)

Table 3. Logistic Regression Models for In-Hospital Mortality by Estimated Glomerular Filtration Rate

Mortality

Estimated glomerular filtration rates (mL/min/1.73 m²)

< 60

≥ 60 - < 90

≥ 90 - 120

≥ 120

All data are presented as odds ratio (95% confidence interval). Logistic models: model 1: unadjusted model; model 2: adjusted model for age and sex; model 3: adjusted model for age, sex and past medical history; model 4: adjusted model for all covariates including age, gender, history, duration of hospitalization, left ventricular ejection fraction, CK-MB, potassium, diameter and length of the stent.

Model 1

7.78 (0.91 - 66.8)

2.41 (0.31 - 18.7)

2.49 (0.32 - 19.6)

1 (Reference)

Model 2

4.57 (0.5 - 41.1)

1.74 (0.21 - 13.9)

2.37 (0.29 - 18.7)

1 (Reference)

Model 3

4.3 (0.46 - 39.6)

1.81 (0.22 - 14.5)

2.49 (0.31 - 19.8)

1 (Reference)

Model 4

2.92 (0.23 - 36.8)

1.16 (0.12 - 10.8)

1.37 (0.14 - 12.7)

1 (Reference)