Abstract 11844: Optimal Therapeutic Management Improves Long-Term Survival in ST-Elevation Myocardial Patients With Altered Glomerular Filtration Rate. A Propensity Score Comparison

Introduction: Patients with chronic kidney disease have more comorbidities and will receive fewer evidence-based therapies. Hypothesis: In a prospective ST-elevated myocardial infarction (STEMI) patient cohort we assessed the effect of an optimal therapeutic management (OTM) according to GFR categories on long-term all-cause mortality. Methods: 1,199 patients admitted for acute STEMI were enrolled between 2007 and 2011 at our university hospital. We classified patients into 4 categories according to estimated GFR, 90 mL/min/1.73 m2 with the Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) equation. Optimal therapeutic management was defined as a combination of reperfusion within 12 hours of symptom onset, primary percutaneous coronary intervention (PCI), double anti-platelet regimen, angiotensin converting enzyme inhibitors, statins, beta blockers, and anti-aldosterone treatment (if left ventricle ejection fraction <40%) upon discharge. The effect of OTM on survival according to GFR categories ...