A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da FAMERP |
Texto Completo: | http://bdtd.famerp.br/handle/tede/476 |
Resumo: | Acute myocardial infarction (AMI) is one of the leading causes of death world widely, and acute kidney injury (AKI) is a common complication after admission due to AMI. Metabolic syndrome (MS) is a very prevalent condition in patients with AMI, but data on its influence on the development of AKI in this clinical context are scarce. Objective: To analyze whether MS is a risk factor for the development of AKI in hospitalized patients diagnosed with AMI. Patients and Methods: This is a single-center, cohort, observational study that evaluated patients with AMI from a prospective data bank in order to assess the role of MS as an independent risk factor for the development of AKI. A total of 1,012 patients admitted with acute ST-elevation myocardial infarction (STEMI) and acute non-ST-segment elevation myocardial infarction (non-STEMI) were included. The diagnostic criterion for AKI was the Kidney Disease: Improving Global Outcomes (KDIGO) definition, during the first seven days of hospitalization. The criterion for SM was the Joint Interim Statement (JIS) definition. Results: The diagnosis of AKI occurred in 34% and MS in 68.6% of the total cohort. Patients with MS developed AKI more frequently (38.3% versus 24.5% no MS, p <0.001). In the multivariate analysis MS was not associated with an increased risk of developing AKI. The factors associated with a higher risk of AKI in the multivariate analysis were male gender (odds ratio [OR] 1.50, 95% confidence interval [CI] 1.05-2.13, p=0.023), diabetes, 95% CI 1.33-2.76, p<0.001), anterior wall STEMI (OR 1.50 95% CI 1.04-2.16, p=0.030), use of vasoactive drugs (OR 2.90 95% CI 1.52-5.51, p=0.001) and diuretic therapy (OR 4.41 95% CI 3.10-6.29, p<0.001). Two factors were associated with a lower risk of AKI: coronary angiography (OR 0.35 95% CI 0.25-0.50, p<0.001) and coronary artery bypass graft (OR 0.05 CI 95% 0.02-0.18, p<0.001) performed during the first seven days of hospital staying. Conclusion: MS was not an independent risk factor for the development of AKI after admission due to AMI. |
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Burdmann, Emmanuel de Almeidahttp://lattes.cnpq.br/6777891253014374Andrade, Patrícia de Fatima Lopes deSterniere, Valéria C. Braga BraileMachado, Maurício de NassauLima, Emerson Quintino de27669535822http://lattes.cnpq.br/3531929864915892Bruetto, Rosana Gobi2018-11-14T15:45:56Z2017-09-20Bruetto, Rosana Gobi. A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio. 2017. 128 f. Tese (Programa de Pós-Graduação em Ciências da Saúde) - Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto.1337http://bdtd.famerp.br/handle/tede/476Acute myocardial infarction (AMI) is one of the leading causes of death world widely, and acute kidney injury (AKI) is a common complication after admission due to AMI. Metabolic syndrome (MS) is a very prevalent condition in patients with AMI, but data on its influence on the development of AKI in this clinical context are scarce. Objective: To analyze whether MS is a risk factor for the development of AKI in hospitalized patients diagnosed with AMI. Patients and Methods: This is a single-center, cohort, observational study that evaluated patients with AMI from a prospective data bank in order to assess the role of MS as an independent risk factor for the development of AKI. A total of 1,012 patients admitted with acute ST-elevation myocardial infarction (STEMI) and acute non-ST-segment elevation myocardial infarction (non-STEMI) were included. The diagnostic criterion for AKI was the Kidney Disease: Improving Global Outcomes (KDIGO) definition, during the first seven days of hospitalization. The criterion for SM was the Joint Interim Statement (JIS) definition. Results: The diagnosis of AKI occurred in 34% and MS in 68.6% of the total cohort. Patients with MS developed AKI more frequently (38.3% versus 24.5% no MS, p <0.001). In the multivariate analysis MS was not associated with an increased risk of developing AKI. The factors associated with a higher risk of AKI in the multivariate analysis were male gender (odds ratio [OR] 1.50, 95% confidence interval [CI] 1.05-2.13, p=0.023), diabetes, 95% CI 1.33-2.76, p<0.001), anterior wall STEMI (OR 1.50 95% CI 1.04-2.16, p=0.030), use of vasoactive drugs (OR 2.90 95% CI 1.52-5.51, p=0.001) and diuretic therapy (OR 4.41 95% CI 3.10-6.29, p<0.001). Two factors were associated with a lower risk of AKI: coronary angiography (OR 0.35 95% CI 0.25-0.50, p<0.001) and coronary artery bypass graft (OR 0.05 CI 95% 0.02-0.18, p<0.001) performed during the first seven days of hospital staying. Conclusion: MS was not an independent risk factor for the development of AKI after admission due to AMI.O infarto agudo do miocárdio (IAM) é uma das principais causas de morte em todo o mundo e a injúria renal aguda (IRA) é complicação frequente após a admissão por IAM. A síndrome metabólica (SM) é condição muito prevalente nos pacientes com IAM, mas pouco se sabe sobre sua influência no desenvolvimento da IRA neste contexto clínico. Objetivo: Analisar se o diagnóstico de SM é fator de risco para o desenvolvimento de IRA em pacientes internados com diagnóstico de IAM. Pacientes e Método: Este é um estudo unicêntrico, de coorte, observacional que avaliou pacientes com IAM de uma banco de dados prospectivo, a fim de analisar o papel da SM como fator de risco independente para o desenvolvimento da IRA. Foram incluídos 1.012 pacientes admitidos com infarto agudo do miocárdio com supradesnível do segmento ST (IAMCST) e infarto agudo do miocárdio sem supradesnível do segmento ST (IAMSST). O critério diagnóstico para IRA foi a definição Kidney Disease: Improving Global Outcomes (KDIGO), nos primeiros sete dias de hospitalização. O critério para SM foi a definição Joint Interim Statement (JIS). Resultados: O diagnóstico de IRA ocorreu em 34% e SM em 68,6% da coorte total. Pacientes com SM desenvolveram IRA mais frequentemente (38,3% versus 24,5% sem SM; p<0,001). Na análise multivariada a SM não foi associada a maior risco de desenvolvimento de IRA. Os fatores associados a maior risco de IRA foram gênero masculino (odds ratio [OR] 1,50, intervalo de confiança de 95% [IC] 1,05-2,13; p=0,023), diabetes (OR 1,92 IC 95% 1,33- 2,76; p<0,001), IAMCST de parede anterior (OR 1,50 IC 95% 1,04-2,16; p=0,030), uso de drogas vasoativas (OR 2,90 IC 95% 1,52-5,51; p=0,001) e terapia com diuréticos (OR 4,41 CI 95% 3.10-6.29; p<0.001. Dois fatores foram associados a menor risco de IRA: cineangiocoronariografia (OR 0,35 IC 95% 0,25-0,50; p<0,001) e cirurgia de revascularização do miocárdio direta (OR 0,05 IC 95% 0,02-0,18; p<0,001) realizadas durante os primeiros sete dias de internação hospitalar. Conclusão: a SM não foi fator de risco independente para o desenvolvimento de IRA após a admissão por IAM.Submitted by Suzana Dias (suzana.dias@famerp.br) on 2018-11-14T15:45:55Z No. of bitstreams: 1 RosanaBruetto_tese.pdf: 4395531 bytes, checksum: d9c812c487bd060076962c5f264d24c5 (MD5)Made available in DSpace on 2018-11-14T15:45:56Z (GMT). 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dc.title.por.fl_str_mv |
A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio |
title |
A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio |
spellingShingle |
A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio Bruetto, Rosana Gobi Myocardial Infarction Diuretics Infarto do Miocárdio Diuréticos CIENCIAS DA SAUDE::8765449414823306929::600 |
title_short |
A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio |
title_full |
A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio |
title_fullStr |
A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio |
title_full_unstemmed |
A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio |
title_sort |
A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio |
author |
Bruetto, Rosana Gobi |
author_facet |
Bruetto, Rosana Gobi |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Burdmann, Emmanuel de Almeida |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/6777891253014374 |
dc.contributor.referee1.fl_str_mv |
Andrade, Patrícia de Fatima Lopes de |
dc.contributor.referee2.fl_str_mv |
Sterniere, Valéria C. Braga Braile |
dc.contributor.referee3.fl_str_mv |
Machado, Maurício de Nassau |
dc.contributor.referee4.fl_str_mv |
Lima, Emerson Quintino de |
dc.contributor.authorID.fl_str_mv |
27669535822 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/3531929864915892 |
dc.contributor.author.fl_str_mv |
Bruetto, Rosana Gobi |
contributor_str_mv |
Burdmann, Emmanuel de Almeida Andrade, Patrícia de Fatima Lopes de Sterniere, Valéria C. Braga Braile Machado, Maurício de Nassau Lima, Emerson Quintino de |
dc.subject.eng.fl_str_mv |
Myocardial Infarction Diuretics |
topic |
Myocardial Infarction Diuretics Infarto do Miocárdio Diuréticos CIENCIAS DA SAUDE::8765449414823306929::600 |
dc.subject.por.fl_str_mv |
Infarto do Miocárdio Diuréticos |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::8765449414823306929::600 |
description |
Acute myocardial infarction (AMI) is one of the leading causes of death world widely, and acute kidney injury (AKI) is a common complication after admission due to AMI. Metabolic syndrome (MS) is a very prevalent condition in patients with AMI, but data on its influence on the development of AKI in this clinical context are scarce. Objective: To analyze whether MS is a risk factor for the development of AKI in hospitalized patients diagnosed with AMI. Patients and Methods: This is a single-center, cohort, observational study that evaluated patients with AMI from a prospective data bank in order to assess the role of MS as an independent risk factor for the development of AKI. A total of 1,012 patients admitted with acute ST-elevation myocardial infarction (STEMI) and acute non-ST-segment elevation myocardial infarction (non-STEMI) were included. The diagnostic criterion for AKI was the Kidney Disease: Improving Global Outcomes (KDIGO) definition, during the first seven days of hospitalization. The criterion for SM was the Joint Interim Statement (JIS) definition. Results: The diagnosis of AKI occurred in 34% and MS in 68.6% of the total cohort. Patients with MS developed AKI more frequently (38.3% versus 24.5% no MS, p <0.001). In the multivariate analysis MS was not associated with an increased risk of developing AKI. The factors associated with a higher risk of AKI in the multivariate analysis were male gender (odds ratio [OR] 1.50, 95% confidence interval [CI] 1.05-2.13, p=0.023), diabetes, 95% CI 1.33-2.76, p<0.001), anterior wall STEMI (OR 1.50 95% CI 1.04-2.16, p=0.030), use of vasoactive drugs (OR 2.90 95% CI 1.52-5.51, p=0.001) and diuretic therapy (OR 4.41 95% CI 3.10-6.29, p<0.001). Two factors were associated with a lower risk of AKI: coronary angiography (OR 0.35 95% CI 0.25-0.50, p<0.001) and coronary artery bypass graft (OR 0.05 CI 95% 0.02-0.18, p<0.001) performed during the first seven days of hospital staying. Conclusion: MS was not an independent risk factor for the development of AKI after admission due to AMI. |
publishDate |
2017 |
dc.date.issued.fl_str_mv |
2017-09-20 |
dc.date.accessioned.fl_str_mv |
2018-11-14T15:45:56Z |
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Bruetto, Rosana Gobi. A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio. 2017. 128 f. Tese (Programa de Pós-Graduação em Ciências da Saúde) - Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto. |
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http://bdtd.famerp.br/handle/tede/476 |
dc.identifier.doi.por.fl_str_mv |
1337 |
identifier_str_mv |
Bruetto, Rosana Gobi. A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio. 2017. 128 f. Tese (Programa de Pós-Graduação em Ciências da Saúde) - Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto. 1337 |
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