Renal Tubulointerstitial Damage Is Associated With Short-Term Cardiovascular Events in Patients With Myocardial Infarction

Background: Urinary beta 2 microglobulin (U-beta 2MG) is a more sensitive and accurate marker of tubulointerstitial damage. The etiology of glomerular damage is related to the occurrence of major adverse cardiovascular events (MACE) in patients with myocardial infarction (MI); however, the prognostic importance of tubulointerstitial damage in patients with ST-segment elevation MI (STEMI) has not been established. The aim of this study was to elucidate whether renal tubulointerstitial damage is associated with the occurrence of MACE in patients after STEMI undergoing percutaneous coronary intervention. Methods and Results: The degree of renal tubulointerstitial damage was evaluated by measuring the U-beta 2MG level in 89 consecutive STEMI patients. There were 22 MACEs during the follow-up period. Patients with MACE had higher U-beta 2MG levels than those without MACE, and the U-beta 2MG level was an independent predictor for MACE. A Kaplan-Meier analysis revealed that the group with higher U-beta 2MG levels corrected for urinary creatinine was associated with a greater risk for MACE. Conclusions: An elevated U-beta 2MG level was associated with the occurrence of MACE in STEMI patients who underwent PCI. Renal tubulointerstitial damage is therefore considered to be associated with the occurrence of MACE. (Circ J 2013; 77: 484-489)