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Objectives: To quantify the impact of baseline renal function on in-hospital and long term mortality in patients with unstable angina/non-ST elevation acute myocardial infarction (UA/NSTEMI) treated with a very early invasive strategy. Design: Prospective cohort study of 1400 consecutive patients with UA/NSTEMI und ergoing coronary angiography and subsequent coronary stenting of the culprit les ion as the primary revascularisation strategy within 24 hours of admission. Patients were stratified according to calculated glomerula r filtration rate (GFR) on admission. Results: In-hospital mortality was 0%amo ng patients with a GFR ≥130 ml/min/1.73 m2, 0.4%with a GFR of 90-129 ml/min/1 .73 m2, 2.6%with a GFR of 60-89 ml/min/1.73m2, and 5.1%with a GFR of < 60 ml/ min/1.73 m2. Cumulative three year survival rates were 92.6%, 95.5%, 91.9%, a nd 76.8%, respectively. Patients with a GFR of < 60 ml/min/1.73 m2 were four ti mes more likely to die in hospital (hazard ratio (HR) 4.0, 95%confidence interv al (CI) 1.8 to 9.1; p=0.001) and four times more likely to die during long term follow up (HR 4.0, 95%CI 2.5 to 6.4; p< 0.001). After adjusting for potential c onfounders, a GFR of < 60 ml/min/1.73 m2 remained a strong independent predictor of long term mortality (HR 2.6, 95%CI 1.5 to 4.5; p=0.001). Conclusions: Basel ine renal function is a strong independent predictor of in-hospital and long te rm mortality after UA/NSTEMI treated with very early revascularisa-tion.
Objectives: To quantify the impact of baseline renal function on-hospital and long term mortality in patients with unstable angina / non-ST elevation acute myocardial infarction (UA / NSTEMI) treated with a very early invasive strategy. Design: Prospective cohort study of 1400 consecutive patients with UA / NSTEMI und ercoronary coronary angiography and subsequent coronary stenting of the culprit lesion as the primary revascularisation strategy within 24 hours of admission. Patients were stratified according to calculated glomerula r filtration rate (GFR) on admission. Results: In -hospital mortality was 0% amo ng patients with a GFR ≥ 130 ml / min / 1.73 m2, 0.4% with a GFR of 90-129 ml / min / 1.73 m2, 2.6% with a GFR of 60-89 ml / patients with a GFR of <60 ml / min / 1.73 m2. Cumulative three year survival rates were 92.6%, 95.5%, 91.9%, a nd 76.8%, respectively. ml / min / 1.73 m2 were four ti mes more likely to die in hospital (hazard ratio (HR) 4.0, 95% confidence interv al (CI) 1.8 to 9.1; p = 0.001) and four times more likely to die during long term follow up (HR 4.0, 95% CI 2.5 to 6.4; p <0.001). After adjusting for potential c onfounders, a GFR of <60 ml / min / 1.73 m 2 of a strong independent predictor of long term mortality (HR 2.6, 95% CI 1.5 to 4.5; p = 0.001). Conclusions: Basel ine renal function is a strong independent predictor of in-hospital and long te rm mortality after UA / NSTEMI treated with very early revascularisation.