Effect of Primary Percutaneous Coronary Intervention on Renal Function in Acute ST Elevation Myocardial Infarction

 Effect of Primary Percutaneous Coronary Intervention on Renal Function in Acute ST Elevation Myocardial Infarction

Objectives: Assess the effect of primary percutaneous coronary intervention (PCI) on renal function in the setting of acute ST elevation myocardial infarction (STEMI). Methods: Retrospective chart review of 270 STEMI patients that underwent primary PCI. Creatinine clearance was calculated using the re-expressed 4–variable Modification of Diet in Renal Disease (MDRD) formulas upon presentation to emergency room and prior to discharge from hospital or death. Results: Mean creatinine level upon presentation was 1.14 ± 0.43 mg/dl and upon discharge 1.07 ± 0.51 mg/dl (p=0.013). Mean CrCl on admission was 77 ± 27 ml/min/1.73m2 and improved to 86 ± 31 ml/min/1.73m2 upon discharge (p<0.001). This improvement was observed in patients with all stages of chronic kidney disease (CKD), including stage III (47 ± 9 vs 55 ± 18 ml/min/1.73m2, p=0.001) and stage IV (24 ± 4 vs 29 ± 10 ml/min/1.73m2; p=0.13). Statistically significant improvement in CrCl (79 ± 28 vs. 86 ± 31 ml/min/1.73m2, p < 0.001) was observed in African American patients (72% of study group). Conclusion: In STEMI patients, primary PCI does not appear to be associated with worsening, but rather an improvement, in renal function upon hospital discharge.