Kidney Week

Abstract: TH-PO611

Glomerular Hyperfiltration as Risk Factor of Major Adverse Cardiovascular Events After Acute Myocardial Infarction

Session Information

• Hypertension and CVD: Epidemiology, Risk Factors, Prevention
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1501 Hypertension and CVD: Epidemiology‚ Risk Factors‚ and Prevention

Authors

• Kim, Jin sug, Division of Nephrology, Department of Internal Medicine, Kyung Hee University, Seoul, Korea (the Republic of)

Jin sug Kim,

• Jeong, Kyung hwan, Division of Nephrology, Department of Internal Medicine, Kyung Hee University, Seoul, Korea (the Republic of)

Kyung hwan Jeong,

• Hwang, Hyeon Seok, Division of Nephrology, Department of Internal Medicine, Kyung Hee University, Seoul, Korea (the Republic of)

Hyeon Seok Hwang,

Background

A reduced glomerular filtration rate (GFR) is a definite risk factor for major adverse cardiovascular event (MACE) in patients with acute myocardial infarction (AMI). While glomerular hyperfiltration (GHF) is associated with early phases of kidney disease, it is unclear whether GHF is associated with higher risk of MACE.

Methods

We enrolled total 9,644 AMI patients with estimated GFR ≥60 mL/min/1.73 m² from prospective population-based national cohort between November 2011 and December 2015. GHF was defined as GFR > 90th percentile after adjustment for age, sex, lean body mass and history of diabetes and hypertension, systolic blood pressure, left ventricular ejection fraction (LVEF) and use of angiotensin converting enzyme inhibitor or receptor blocker. The primary endpoint was a combination of 3-year major MACEs after AMI occurrence.

Results

The GFR in 964 patients with GHF was 113.0 ± 13.1 and it was significantly higher than those in patients with normal GFR (87.7 ± 13.8; P < 0.001). The cumulative event rate of MACEs was significantly higher in patients with GHF (P = 0.033) In multivariable Cox-regression analysis, compared to patients with normal GFR, GHF increased the 1.39-fold risk of MACE (95% confidence interval [CI] 1.15-1.67). Patients with GHF had significantly higher risk of all-cause mortality (hazard ratio [HR] 1.70; 95% CI 1.30-2.23), cardiac death (HR 1.84; 95% CI 1.30-2.60) and ischemic stroke (HR 1.53; 95% CI 1.01-2.33). However, the risk of recurrent MI and rehospitalization for heart failure was not significantly increased.

Conclusion

The GHF was independently associated with increased risk of MACE after AMI and the hazardous effects of GHF was pronounced in all-cause mortaltity, cardiac death and ischemic stroke.