Impact of initial 24-h urine output on short-term outcomes in patients with ST-segment elevation myocardial infarction admitted without cardiogenic shock and renal dysfunction. Issue 1 (May 2015)

• Record Type: Journal Article
• Authors: Huang, Bi; Yang, Yanmin; Zhu, Jun; Liang, Yan; Tan, Huiqiong; Yu, Litian; Gao, Xin; Li, Jiandong; Zhang, Han; Wang, Juan; Wan, Huaibin
• Is Part Of: Atherosclerosis. Volume 240:Issue 1(2015)
• Page Start: 137
• Page End: 143
• Publication Date: 2015-05
• Subjects: Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2015.03.005
• Languages: English
• ISSNs: 0021-9150

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Objectives</title> <p id="abspara0010">Our study aims to evaluate the prognostic value of initial 24-h urine output (UO) in patients with ST-segment elevation myocardial infarction (STEMI) admitted without cardiogenic shock and renal dysfunction, and to determine the additional risk stratification offered by adding initial 24-h UO to TIMI risk score (TRS).</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">Data from 7078 consecutive STEMI patients in a multi-center registry were retrospectively analyzed. Patients were divided into 4 groups according to initial 24-h UO quartiles. The primary endpoints were 7- and 30-day all-cause mortality.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">Patients in the lowest UO quartile (≤1020 mL) had significantly higher 7- and 30-day all-cause mortality rates, cardiogenic shock, and major adverse cardiovascular events (MACE) than those in other groups (all <italic>P</italic> < 0.05). After multivariate adjustment, initial 24-h UO ≤1020 mL was independently associated with an increased risk in 7-day all-cause mortality (HR = 4.649, 95%CI 3.348–6.455) and 30-day all-cause mortality (HR = 3.775, 95%CI 2.891–4.931) as well as 7-day MACE (HR = 1.845, 95%CI 1.563–2.179) and 30-day MACE (HR = 1.818, 95%CI 1.553–2.127). Initial 24-h UO provided additional risk stratification across all TRS groups and improved the discriminatory ability of TRS with respect to 7-day all-cause mortality (c-statistic from 0.704 to 0.764) and 30-day all-cause mortality (c-statistic from 0.706 to 0.743).</p> </sec> <sec> <title id="sectitle0030">Conclusion</title> <p id="abspara0025">Reduced initial 24-h UO (≤1020 mL) was associated with an increased risk in 7- and 30-day all-cause mortality and MACE in STEMI patients admitted without cardiogenic shock and renal dysfunction. The combination of initial 24-h UO and TRS improved short-term outcome prediction when compared to TRS alone, particularly in patients with initial 24-h UO ≤1020 mL.</p> </sec> </abstract>