Impact of Chronic Kidney Disease on Postinfarction Inflammation, Oxidative Stress, and Left Ventricular Remodeling

Kotaro Naito, Toshihisa Anzai, Tsutomu Yoshikawa, Atsushi Anzai, Hidehiro Kaneko, Takashi Kohno, Toshiyuki Takahashi, Akio Kawamura, Satoshi Ogawa

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)831-838
Number of pages8
JournalJournal of Cardiac Failure
Volume14
Issue number10
DOIs
Publication statusPublished - 2008 Dec

Keywords

  • Acute myocardial infarction
  • chronic kidney disease
  • inflammation
  • oxidative stress

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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