Impact of Renal Impairment on Coronary Vasculature among Patients Undergoing Primary Percutaneous Coronary Intervention and its Effect on Hospital Stay Outcome

Abstract
Background: The decrease in glomerular filtration rate is independently associated with increase of cardiovascular disease and cardiovascular death. Cardiovascular causes, mainly myocardial infraction are responsible for half of deaths in Chronic Kidney Disease (CKD) patients.
Aim of Study: To study impact of renal impairment on coronary vasculature among patients undergoing primary PCI and its effect on hospital stay outcome.
Methods: A prospective observational study conducted from June 2016 to November 2016, at Cardiovascular Medicine Department, Tanta University Hospitals in Gharbia Governo-rate, Egypt. The study enrolled 138 consecutive adultpatients of both genders who were diagnosed with definite ST-segmentelevation myocardial infarction within 12 hours from the time ofsymptoms onset and were treated by primary percutaneous coronaryintervention. EGFR was calculated and the patient were divided into four groups according to the severity of the renal impairment.
Results: The current study showed that reduced renal function either estimated by eGFR was associated with sig-nificantly lower rates of suboptimal perfusion assessed by angiographic and by electrocardiographic criteria.Both the epicardial coronary artery flow and the myocardial perfusion were both reduced with reduced renal function when compared to the group with normal kidney functions.
Conclusion: CKD is not uncommon finding among pa-tients with STEMI and the rate of no reflow showed significant increment with worsening of renal function. Both epicardial coronary flow and myocardial perfusion are reduced in CKD patients with STEMI and CKD was independently and in-versely associated with the rate of procedural success.