Objective: To explore the risk factors for Type 1 cardio-renal syndrome (CRS1) after ST-segment elevation myocardial infarction (STEMI).
Methods: A total of 378 patients with STEMI were divided into two groups: a CRS1 group (n=98) and a non-CRS1 group (n=280). Clinical characteristics in the 2 groups were compared, and independent risk factors for CRS1 after STEMI were analyzed, and the effect of emergency percutaneous coronary intervention (PCI) on CRS1 in patients after STEMI were assessed.
Results: In the 378 STEMI patients, CRS1 was found in 98 patients (25.9%). Between the 2 groups, there was significant difference in 12 parameters, including age, history of diabetes, admission mean arterial pressure, admission systolic blood pressure, admission heart rate, Killip classification, left ventricular ejection fraction, baseline serum creatinine, baseline evaluated glomerular filtration rate (eGFR), emergency PCI, β-blockers and angiotensin converting enzyme inhibitor/angiotensin, receptor antagonist (ACEI/ARB) application (all P<0.05). Multivariate logistic regression showed that age, history of diabetes, admission systolic blood pressure, Killip classification, reduced left ventricular ejection fraction, reduced eGFR, emergency PCI nonundergo and ACEI/ARB non-use were independent risk factors for CRS1 after STEMI. In the 256 patients undergoing emergency PCI, 50 patients (19.5%) had CRS1. The door-ball time and the amount of contrast agent in the CRS1 group were significantly higher than those in the non- CRS1 group (both P<0.05), but there was no significant difference in the blood flow in the "culprit vessel" after the PCI (P>0.05).
Conclusion: CRS1 is a common complication of STEMI, which is associated with many factors. Immediate revascularization can reduce the incidence of CRS1 in patients with ST-segment elevation myocardial infarction.