Clinical Characteristics And Treatment Observation Of Chronic Renal Failure With Acute Myocardial Infarction

Objective : We sought to compare clinical characteristics and therapeutic schedule of CRF and non-CKD patients with AMI. In order to deepen the cognition of CRF combined with AMI and investigate the efficacy and safety of PCI in CRF patients with AMI.to improve the patients’ prognosis.Methods: This observational study identifies 42 CRF with AMI compared with non-CKD patients(n =51).which hospitalized between January 1st, 2012 and January 1st, 2016 in The Second Affiliated Hospital of Chongqing Medical University. And compared treatment efficacy of group PCI and drugs in hospital. Then followed up and observed the prognosis of the subgroups for 2~6 months.Results: 1)Patients of group CRF were older(73± 10.2 vs 66.0± 11.8)and the majority were female(54.8% vs 31.4%),the proportion of complicating hypertension, diabetes and hyperlipidemia was higher. But the proportion of patients with smoking history and morbidity of coronary heart disease was lower(P<0.05). 2) Clinically significant differences among CRF and no-CKD patients were lower chest pain rate( 40.5% vs 72.5%), higher dyspnea(54.8% vs 13.7%)and cardiogenic shock(45.2% vs 15.7 %)rate; ECG findings showed more NSTEMI(76.2%vs39.2%) and arrhythmias(59.5% vs 27.5%) instead of ST-segment elevation(23.8% vs 60.8%); Troponin showed a higher positive rate, but increased to a small extent(P<0.05). what’s more, the in-hospital mortality was significantly higher(47.6% vs 39.4%). 3) The percentage of patients accepted the treatment of PCI and drugs was significantly lower in group CRF than that in group non-CKD(P<0.05). 4)In subgroups, the effective rate of PCI was higher compared with medicine treatment in hospital(p<0.05). During followe-up 2 ~6 moths after discharge, group PCI can relieve angina and reduce the risk of re-infarction more effectively(p<0.05).There was no significant difference in cardiovascular events, such as sudden cardiac death, cardiogenic shock, heart failure and death(P> 0.05).Conclusion:1)Group CRF existed more cardiovascular risk factors and comorbidities. In addition,this patients had atypical symptoms and Lab Results what likely contribute to poor outcomes. 2) In group CRF, emergency PCI and drugs are still underutilized and selection emergency PCI can be more effective to relieve symptoms of AMI and improve the patients’ prognosis.