Association of renal dysfunction with cardiovascular outcomes among patients with acute myocardial infarction in a selected tertiary care hospital

Introduction: Chronic kidney disease is a major global health problem and it is an important risk factor for cardiovascular disease and adverse outcomes. Measurement of eGFR on admission could be reliably used in the risk stratification of patients with AMI and control of eGFR leads to reduction in short term outcomes of patients with AMI. Aim: To assess the association of renal dysfunction with cardiovascular outcomes among patients with acute myocardial infarction.Methodology: A prospective observational study was conducted on 100 patients admitted in hero DMC heart institute (HDHI) Ludhiana by convenience sampling. Socio demographic profile, clinical profile, renal dysfunction by MDRD GFR equation (Levey 2006) and self structured tool to assess cardiovascular outcomes was used to collect data. Data was collected from patient records, bio-physiological measures and by interview method.Results: 100 patients were observed for 30 days/or till discharge. Out of 100 patients 34% of the subjects had normal kidney function (>90 ml/min/1.73 m2), followed by 29% had mild CKD (60-89 ml/min/1.73m2), 26% had moderate CKD (30-59 ml/min/1.73 m2), 7% had severe CKD (15-29 ml/min/1.73 m2) and 4% had end stage kidney disease (<15 ml/min/1.73 m2) as per MDRD GFR equation with mean GFR ± SD was 73.23±33.54 ml/min/1.73 m2. 1% of the subject had atrial fibrillation with mild CKD, followed by 3% had with moderate CKD and 1% had with severe CKD. 3% of the subjects had ventricular tachycardia with normal kidney function, followed by 1% had with mild CKD, 4% had with moderate CKD and 1% had with severe CKD. 2% of the subjects had cardiogenic shock with normal kidney function, followed by 3% had with mild CKD,4% had with moderate CKD,1% had with end stage renal failure. 1% of the subject had cardiac arrest with mild CKD, followed by 3% had with moderate CKD, 1% had with severe CKD. 1% of the subject had death with CVD with mild CKD, followed by 4% had with moderate CKD, 1% had with severe CKD. 1% of the subject readmitted within 30 days of observation. Mean days ± SD was 9.34 ± 5.29. There was significant association of readmission (p=.009) and length of hospital stay (p= .038) with renal dysfunction.Conclusion: The present study concluded that most of the patients with AMI had renal dysfunction. Renal dysfunction was significantly associated with readmission and length of hospital stay in cardiovascular outcomes. Although, no significant association was found between atrial fibrillation, ventricular tachycardia, cardiogenic shock, cardiac arrest and death with CVD among cardiovascular outcomes with renal dysfunction but these cardiovascular outcomes were recorded among patients with AMI.