TY - JOUR
T1 - Impact of Chronic Kidney Disease on Postinfarction Inflammation, Oxidative Stress, and Left Ventricular Remodeling
AU - Naito, Kotaro
AU - Anzai, Toshihisa
AU - Yoshikawa, Tsutomu
AU - Anzai, Atsushi
AU - Kaneko, Hidehiro
AU - Kono, Takashi
AU - Takahashi, Toshiyuki
AU - Kawamura, Akio
AU - Ogawa, Satoshi
PY - 2008/12
Y1 - 2008/12
N2 - Background: Patients with chronic kidney disease (CKD) have poor clinical outcomes after myocardial infarction (MI). However, the precise mechanisms are unclear. We sought to determine the prognostic significance of CKD in patients with MI in relation to left ventricular (LV) remodeling. Methods and Results: We examined 120 consecutive patients with a reperfused first anterior ST-elevation MI. Patients were divided into 2 groups according to the presence or absence of CKD, defined as estimated glomerular filtration rates <60 mL·min·1.73 m2. Patients with CKD had a higher incidence of in-hospital cardiac death and readmission for heart failure during follow-up, in association with a greater LV volume and lower LV ejection fraction 2 weeks after MI compared with those without CKD. Cox proportional hazards model analysis revealed that CKD was an independent predictor of major adverse cardiac events (hazard ratio = 3.13, P = .001). Plasma interleukin-6 on admission, and peak serum C-reactive protein, and malondialdehyde-modified low-density lipoprotein levels during convalescence, were higher in patients with CKD than in those without. Conclusions: Patients with CKD had poorer clinical outcomes and accelerated infarct expansion in association with enhanced inflammation and oxidative stress, as compared with non-CKD patients, suggesting a major impact of CKD in the development of LV remodeling after MI.
AB - Background: Patients with chronic kidney disease (CKD) have poor clinical outcomes after myocardial infarction (MI). However, the precise mechanisms are unclear. We sought to determine the prognostic significance of CKD in patients with MI in relation to left ventricular (LV) remodeling. Methods and Results: We examined 120 consecutive patients with a reperfused first anterior ST-elevation MI. Patients were divided into 2 groups according to the presence or absence of CKD, defined as estimated glomerular filtration rates <60 mL·min·1.73 m2. Patients with CKD had a higher incidence of in-hospital cardiac death and readmission for heart failure during follow-up, in association with a greater LV volume and lower LV ejection fraction 2 weeks after MI compared with those without CKD. Cox proportional hazards model analysis revealed that CKD was an independent predictor of major adverse cardiac events (hazard ratio = 3.13, P = .001). Plasma interleukin-6 on admission, and peak serum C-reactive protein, and malondialdehyde-modified low-density lipoprotein levels during convalescence, were higher in patients with CKD than in those without. Conclusions: Patients with CKD had poorer clinical outcomes and accelerated infarct expansion in association with enhanced inflammation and oxidative stress, as compared with non-CKD patients, suggesting a major impact of CKD in the development of LV remodeling after MI.
KW - Acute myocardial infarction
KW - chronic kidney disease
KW - inflammation
KW - oxidative stress
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U2 - 10.1016/j.cardfail.2008.07.233
DO - 10.1016/j.cardfail.2008.07.233
M3 - Article
C2 - 19041046
AN - SCOPUS:56449086727
SN - 1071-9164
VL - 14
SP - 831
EP - 838
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 10
ER -