RESUMO
Aiming to assess the relationships between renal function and ST-segment elevation myocardial infarction (MI) clinical course and remote outcomes in patients with preserved systolic left ventricular (LV) function (LV ejection fraction > 40%) estimated glomerular filtration rates (eGFR) were evaluated on 1st and 3rd -10th MI day (n = 491). On 3rd-10th day of MI in patients with acute heart failure (HF) symptoms on admission day (1st group, n = 153) eGFR < 70 ml/min x per body surface unit was independent marker of re-infarction (Hazzard Ratio (HR) with 95% confidence intervals (95% CI) = 4,08 [1,72 -11,73], P < 0,01) and cardiovascular death (CVD) (HR [95% CI] = 3,61 [1,09 - 11,99], P = <0,05) during three years of follow-up. In patient without acute HF (2nd group, n = 338) eGFR < 68 ml/min was predictive of CVD within three years post-MI (HR [95% CI] = 7,13 [2,06 - 24,74], P = 0,002). eGFR did not correlate with myocardial damage markers. In the 1st group eGFR on the 3rd MI day was negatively correlated with tumor-necrosis factor alpha (TNF-alpha) and vascular endothelial growth factor levels. There were no correlation between systemic inflammation activation with eGFR in 2nd study group indicating different mechanisms of renal dysfucntion in patients with and without acute HF and preserved LV function.
