Prognostic value of renal kidney disease on the mortality of patients with acute myocardial infarction

Introduction The correlations between chronic kidney disease (CKD) and atherosclerotic disease include both early onset and severe evolution of the atherosclerotic lessions, as well as a higher risk for acute cardiovascular events (Levey et al 1998). The high prevalence and severity of atherosclerotic lessions in patients with CKD, is explained by the often cumulative presence of hypertension, diabetes mellitus, dyslipidemia, hyperhomocysteinemia, inactive lifestyle, systemic inflammation and endothelial dysfunction (Rosengren et al 1990). CKD is associated with high cardiovascular mortality and morbidity risk that increases in parallel with estimated glomerular filtration rate (eGRF) decreasing (Levey et al 1998). The risk of death by myocardial infarction is higher in patients with CKD, especialy in the last stage of CKD, when acute myocardial infarction is 40% more frequent, when compared to patients with normal renal function (Levey et al 1998). The long and medium term prognosis in patients with acute myocardial infarction, is influenced by multiple factors that include: age >75 years, previous myocardial infarction, severity of coronary lesions, pharmacologic treatment, interventional or surgical revascularisation procedures, cardiac disfunction, obesity and comorbidities (CKD, diabetes mellitus) (Smolina et al 2012). The aim was to evaluate the impact of chronic kidney disease, estimated by seric levels of cystatin C, on one year mortality after acute myocardial infarction (AMI).