Renal dysfunction as a risk factor for painless myocardial infarction: results from Korea Acute Myocardial Infarction Registry
Clinical Research in Cardiology, 05/14/2012
Choi JS et al. – Poorer outcomes of painless myocardial infarction (MI) patients and the increased probability of painless MI proportional to declining glomerular filtration rate (GFR) indicate that the possibility of painless MI should be considered in patients with renal dysfunction, particularly concomitant with diabetes mellitus.Methods
- Study population consisted of 9,735 patients (63 ± 13 years, men 70.7 %), whose discharge diagnosis by cardiac enzyme and electrocardiogram was MI.
- The study subjects were divided into two groups according to presence of chest pain (painful MI group, n = 8,249; painless MI group, n = 1486).
- Rates of in–hospital death, 1–month and 12–month composite MACE, cardiac death, and non–cardiac death were significantly higher in painless MI patients.
- In a multivariate logistic analysis, compared with glomerular filtration rate (GFR) > 90 mL/min/1.73 m2, odds ratio of painless MI was increased proportionally in patients with GFR of 30–59, 15029 and <15 mL/min/1.73 m2 (odds ratio [OR] 1.25, 95 % confidence interval [CI] 1.05–1.49; OR 1.88, CI 1.39–2.53; OR 2.32, CI 1.65–3.26) In addition, the concomitant presence of renal dysfunction and diabetes mellitus significantly affected the prevalence of painless MI.