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Usefulness of creatinine clearance in predicting early and late death after primary angioplasty for acute myocardial infarction

      Emerging data have suggested that renal dysfunction is an important predictor of outcome in patients with cardiovascular disease, including acute myocardial infarction (AMI).
      • Ruilope L.M.
      • van Veldhuisen D.J.
      • Ritz E.
      • Luscher T.F.
      Renal function the Cinderella of cardiovascular risk profile.
      ,
      • Mann J.F.E.
      • Gerstein H.C.
      • Pogue J.
      • Bosch J.
      • Yusif S.
      HOPE Investigators
      Renal insufficiency as a predictor of cardiovascular outcomes and the impact of ramipril the HOPE randomized trial.
      ,
      • Ruilope L.M.
      • Salvetti A.
      • Jamerson K.
      • Hansson L.
      • Warnold I.
      • Wedel H.
      • Zanchetti A.
      Renal function and intensive lowering of blood pressure in hypertensive participants of the Hypertension Optimal Treatment (HOT) Study.
      ,
      • Dries D.L.
      • Exner D.V.
      • Domanski M.J.
      • Greenberg B.
      • Stevenson L.W.
      The prognostic implications of renal insufficiency in asymptomatic and symptomatic patients with left ventricular dysfunction.
      ,
      • Hillege H.L.
      • Girbes A.R.J.
      • de Kam P.J.
      • Boomsma F.
      • de Zeeuw D.
      • Charlesworth A.
      • Hampton J.R.
      • van Veldhuisen D.J.
      Renal function, neurohumoral activation and survival in patients with chronic heart failure.
      ,
      • Herzog C.A.
      • Ma J.Z.
      • Collins A.J.
      Poor long-term survival after acute myocardial infarction among patients on long-term dialysis.
      ,
      • Al Suwaidi J.
      • Reddan D.N.
      • Williams K.
      • Pieper K.S.
      • Harrington R.A.
      • Califf R.M.
      • Granger C.B.
      • Ohman E.M.
      • Holmes D.R.
      GUSTO-IIb GUSTO-III, PURSUIT, and PARAGON-A Investigators
      Prognostic implications of abnormalities in renal function in patients with acute coronary syndromes.
      ,
      • Sorensen C.R.
      • Brendorp B.
      • Rask-Madsen C.
      • Kober L.
      • Kjoller E.
      • Torp-Pedersen C.
      The prognostic importance of creatinine clearance after acute myocardial infarction.
      ,
      • Scott Wright R.
      • Reeder G.S.
      • Herzog C.A.
      • Albright R.C.
      • Williams B.A.
      • Dvorak D.L.
      • Miller W.L.
      • Murphy J.G.
      • Kopecky S.L.
      • Jaffe A.S.
      Acute myocardial infarction and renal dysfunction a high-risk combination.
      Among patients with AMI, those with end-stage renal disease on dialysis are known to have a particularly poor long-term survival.
      • Herzog C.A.
      • Ma J.Z.
      • Collins A.J.
      Poor long-term survival after acute myocardial infarction among patients on long-term dialysis.
      Although these patients have usually been excluded from trials of reperfusion therapy, many patients with AMI have evidence of mild or moderate renal insufficiency due to diabetic or hypertensive kidney disease. The degree of renal impairment is often under-recognized, because most clinicians rely on serum creatinine alone as a measure of renal function. Recent studies have shown that even mild or moderate renal impairment is associated with adverse outcomes in patients with hypertension or heart failure, but few data exist regarding this relation in patients with AMI.
      • Mann J.F.E.
      • Gerstein H.C.
      • Pogue J.
      • Bosch J.
      • Yusif S.
      HOPE Investigators
      Renal insufficiency as a predictor of cardiovascular outcomes and the impact of ramipril the HOPE randomized trial.
      ,
      • Ruilope L.M.
      • Salvetti A.
      • Jamerson K.
      • Hansson L.
      • Warnold I.
      • Wedel H.
      • Zanchetti A.
      Renal function and intensive lowering of blood pressure in hypertensive participants of the Hypertension Optimal Treatment (HOT) Study.
      ,
      • Dries D.L.
      • Exner D.V.
      • Domanski M.J.
      • Greenberg B.
      • Stevenson L.W.
      The prognostic implications of renal insufficiency in asymptomatic and symptomatic patients with left ventricular dysfunction.
      ,
      • Hillege H.L.
      • Girbes A.R.J.
      • de Kam P.J.
      • Boomsma F.
      • de Zeeuw D.
      • Charlesworth A.
      • Hampton J.R.
      • van Veldhuisen D.J.
      Renal function, neurohumoral activation and survival in patients with chronic heart failure.
      ,
      • Sorensen C.R.
      • Brendorp B.
      • Rask-Madsen C.
      • Kober L.
      • Kjoller E.
      • Torp-Pedersen C.
      The prognostic importance of creatinine clearance after acute myocardial infarction.
      ,
      • Scott Wright R.
      • Reeder G.S.
      • Herzog C.A.
      • Albright R.C.
      • Williams B.A.
      • Dvorak D.L.
      • Miller W.L.
      • Murphy J.G.
      • Kopecky S.L.
      • Jaffe A.S.
      Acute myocardial infarction and renal dysfunction a high-risk combination.
      This study investigates the effect of baseline renal function on early and late clinical outcome after primary angioplasty for AMI.
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