MORTALITY OF PATIENTS WITH ST-ELEVATION MI AND ASSOCIATED RENAL IMPAIRMENT - ONE MONTH FOLLOW-UP STUDY

Abstract

Background: ST-elevation myocardial infarction (STEMI) remains a leading cause of morbidity and mortality worldwide, and outcomes are further influenced by the coexistence of comorbidities such as renal impairment. Renal dysfunction is prevalent among cardiovascular patients and has been shown to worsen prognosis, yet limited local data exist on its short-term impact in STEMI. Evaluating this association is essential to guide risk stratification, improve clinical decision-making, and enhance patient care in populations at higher risk.

Objective: To determine the frequency of one-month follow-up mortality in patients presenting with STEMI, with a focus on the effect of renal impairment.

Methods: This descriptive study was conducted in the Department of Cardiology, Lady Reading Hospital (LRH), Peshawar, over the defined study period. A total of 111 patients, aged 30 to 75 years and diagnosed with STEMI, were enrolled through consecutive non-probability sampling. Diagnosis was based on clinical presentation of central chest pain with significant ST-segment elevation on electrocardiography. Patients were excluded if they had eGFR <15 mL/min/1.73m², were on renal replacement therapy, or had a prior history of coronary interventions or CABG. Baseline demographic and clinical characteristics were recorded, and patients were followed up for 30 days to assess mortality outcomes. Data were analyzed using SPSS version 26.

Results: The mean age of participants was 55.03 ± 11.22 years, with 62.2% older than 50 years and 60.4% being male. The mean pain duration before presentation was 12.72 ± 3.79 hours. Obesity (BMI >24.0 kg/m²) was present in 63.1%, while hypertension and diabetes were observed in 28.8% and 29.7% respectively. Renal impairment was identified in 26 patients (23.4%). Overall one-month follow-up mortality was 12.6% (14/111). Mortality was significantly higher among patients with renal impairment at 78.6% (11/14) compared to only 15.5% (3/14) in those without renal impairment (p = 0.000). Elderly males with raised BMI were particularly more vulnerable to adverse outcomes.

Conclusion: A statistically significant association was observed between renal impairment and increased short-term mortality in STEMI patients. These findings emphasize the prognostic importance of renal function and support the incorporation of strict renal monitoring into the routine management of STEMI to reduce early mortality.