Decreased glomerular filtration rate is a significant and independent risk for in-hospital mortality in Japanese patients with acute myocardial infarction: report from the Hokkaido acute myocardial infarction registry

Renal dysfunction is a significant risk factor in the prognosis of patients with cardiovascular diseases. We sought to determine the relationship between estimated glomerular filtration rate (eGFR) values and in-hospital mortality in Japanese acute myocardial infarction (AMI) patients. A total of 2266 consecutive AMI patients admitted to 22 hospitals in Hokkaido were registered. The eGFR values were determined using the following equation: eGFR=194 × (serum creatinine)−1.094 × (age)−0.287 ( × 0.739 if female). Patients were classified into four groups according to their eGFR values: ⩾60 (n=1304), 30–59 (n=810), 15–29 (n=87) and <15 ml min−1 per 1.73 m2 (n=65). A total of 110 patients (4.9%) died during hospitalization. The in-hospital mortality rate was significantly higher in patients with reduced eGFR values at 2.3, 5.4, 24.1 and 23.1% for eGFR values of ⩾60, 30–59, 15–29, and <15 ml min−1 per 1.73 m2, respectively. The odds ratios for in-hospital all cause death were 8.26 (95% confidence interval (CI): 2.22–30.77) for eGFR<15 ml min−1 per 1.73 m2 and 3.42 (95% CI: 1.01–11.61) for eGFR 15–29 ml min−1 per 1.73 m2 compared with eGFR ⩾60 ml min−1 per 1.73 m2. Similarly, the odds ratios for in-hospital cardiac death were 8.43 (95% CI: 1.82–39.05) for eGFR<15 ml min−1 per 1.73 m2 and 5.47 (95% CI: 1.51–19.80) for eGFR 15–29 ml min−1 per 1.73 m2. In conclusion, the eGFR of <30 ml min−1 per 1.73 m2 was a significant and independent risk for in-hospital mortality in abroad cohort of Japanese patients with AMI.