Association between decreased estimated glomerular filtration rates and long-term mortality in patients with acute myocardial infarction

Background: The impact of estimated glomerular filtration rate (eGFR) on the risk of death in individuals with acute myocardial infarction (AMI) is not well established. The aim of this study was to investigate the association of eGFR with long term mortality among patients with ST elevation myocardial infarction (STEMI).
Methods: A cohort of 2949 STEMI undergoing primary coronary intervention (PCI) 2008–2020 were enrolled in the Tel-Aviv Sourasky Medical Center, Israel. EGFR was estimated by the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). Subjects were categorized into 5 groups according to quintiles of eGFR: ≤57 mL/min/1.73 m2, 57-70 mL/min/1.73 m2, 70-80 mL/min/1.73 m2, 80-93 mL/min/1.73 m2 and > 93 mL/min/1.73 m2. Hazard ratios (HRs), corresponding 95% confidence intervals (CIs) as well as the nomogram were assessed using Cox regression models.
Results: The median EGFR was 75.6 mL/min/1.73 m2. There was a significant difference in all cause mortality between the five eGFR groups (P<0.001). Kaplan-Meier curves showed decreased survival in the lowest eGFR quintile vs. highest eGFR quintile (P<0.001).
Multivariate analysis revealed that low eGFR was an independent risk factor for mortality during one year follow-up.
Conclusion: Decreased renal function was a significant predictor of mortality after one year in patients with STEMI.