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Suboptimal medical care of patients with ST-elevation myocardial infarction and renal insufficiency: results from the Korea Acute Myocardial Infarction Registry.
- Source :
-
BMC nephrology [BMC Nephrol] 2012 Sep 11; Vol. 13, pp. 110. Date of Electronic Publication: 2012 Sep 11. - Publication Year :
- 2012
-
Abstract
- Background: The clinical outcomes of ST-segment elevation myocardial infarction (STEMI) are poor in patients with renal insufficiency. This study investigated changes in the likelihood that patients received optimal medical care throughout the entire process of myocardial infarction management, on the basis of their glomerular filtration rate (GFR).<br />Methods: This study analyzed 7,679 patients (age, 63 ± 13 years; men 73.6%) who had STEMI and were enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to August 2008. The study subjects were divided into 5 groups corresponding to strata used to define chronic kidney disease stages.<br />Results: Patients with lower GFR were less likely to present with typical chest pain. The average symptom-to-door time, door-to-balloon time, and symptom-to-balloon time were longer with lower GFR than higher GFR. Primary reperfusion therapy was performed less frequently and the results of reperfusion therapy were poorer in patients with renal insufficiency; these patients were less likely to receive adjunctive medical treatment, such as treatment with aspirin, clopidogrel, β-blocker, angiotensin-converting enzyme (ACE) inhibitor/angiotensin-receptor blocker (ARB), or statin, during hospitalization and at discharge. Patients who received less intense medical therapy had worse clinical outcomes than those who received more intense medical therapy.<br />Conclusions: Patients with STEMI and renal insufficiency had less chance of receiving optimal medical care throughout the entire process of MI management, which may contribute to worse outcomes in these patients.
- Subjects :
- Aged
Comorbidity
Delivery of Health Care classification
Female
Humans
Male
Middle Aged
Myocardial Infarction diagnosis
Prevalence
Renal Insufficiency diagnosis
Republic of Korea epidemiology
Risk Factors
Treatment Outcome
Delivery of Health Care statistics & numerical data
Glomerular Filtration Rate
Myocardial Infarction epidemiology
Myocardial Infarction therapy
Registries
Renal Insufficiency epidemiology
Renal Insufficiency therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2369
- Volume :
- 13
- Database :
- MEDLINE
- Journal :
- BMC nephrology
- Publication Type :
- Academic Journal
- Accession number :
- 22966970
- Full Text :
- https://doi.org/10.1186/1471-2369-13-110