Renal hyperfiltration as risk factor of major adverse cardiovascular events in patients with acute myocardial infarction

Abstract The potential interaction between the heart and kidneys is thought to contribute to the development of renal hyperfiltration (RHF). However, the clinical implications of RHF remain unclear in patients with acute myocardial infarction (AMI). A total of 9561 AMI patients with estimated glomer...

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Main Authors: Jin Sug Kim, Weon Kim, Hyo-jin Lee, Kyung Hwan Jeong, Su Jin Jeong, Myung Ho Jeong, Jin-Yong Hwang, Seung Ho Hur, Hyeon Seok Hwang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-07768-y
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author Jin Sug Kim
Weon Kim
Hyo-jin Lee
Kyung Hwan Jeong
Su Jin Jeong
Myung Ho Jeong
Jin-Yong Hwang
Seung Ho Hur
Hyeon Seok Hwang
author_facet Jin Sug Kim
Weon Kim
Hyo-jin Lee
Kyung Hwan Jeong
Su Jin Jeong
Myung Ho Jeong
Jin-Yong Hwang
Seung Ho Hur
Hyeon Seok Hwang
author_sort Jin Sug Kim
collection DOAJ
description Abstract The potential interaction between the heart and kidneys is thought to contribute to the development of renal hyperfiltration (RHF). However, the clinical implications of RHF remain unclear in patients with acute myocardial infarction (AMI). A total of 9561 AMI patients with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 were enrolled from a large nationwide cohort. RHF was defined as eGFR > 90th percentile after multiple adjustments. The primary endpoint was a combination of 3 year major adverse cardiovascular events (MACEs) after AMI treatment. The cumulative event rate of MACEs was significantly higher in patients with RHF. In multivariable Cox-regression analysis, RHF increased the 1.34-fold risk of MACE (95% confidence interval [CI] 1.12–1.62) compared to those without RHF. Patients with RHF had a significantly higher risk of all-cause mortality (hazard ratio [HR] 1.64; 95% CI 1.25–2.14) and cardiac death (HR 1.78; 95% CI 1.26–2.51). There was a U-shaped association between the adjusted risk of MACEs and eGFR, with the risk increasing as eGFR exceeded approximately 100 mL/min/1.73 m2. The results demonstrated a consistent pattern in the 1:1 PS-matched population. Our study offers new insights into the risk stratification of AMI patients with RHF.
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spelling doaj-art-5e1a49b11ad5421ba3d0803b72cb4c202025-08-20T03:38:16ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-07768-yRenal hyperfiltration as risk factor of major adverse cardiovascular events in patients with acute myocardial infarctionJin Sug Kim0Weon Kim1Hyo-jin Lee2Kyung Hwan Jeong3Su Jin Jeong4Myung Ho Jeong5Jin-Yong Hwang6Seung Ho Hur7Hyeon Seok Hwang8Division of Nephrology, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University College of MedicineDivision of Cardiology, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University College of MedicineDivision of Nephrology, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University College of MedicineDivision of Nephrology, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University College of MedicineStatistics Support Part, Medical Science Research Institute, Kyung Hee University Medical CenterDepartment of Internal Medicine and Heart Center, Chonnam National University HospitalDepartment of Internal Medicine, Gyeongsang National UniversityDivision of Cardiology, Department of Internal Medicine, Keimyung University Dongsan HospitalDivision of Nephrology, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University College of MedicineAbstract The potential interaction between the heart and kidneys is thought to contribute to the development of renal hyperfiltration (RHF). However, the clinical implications of RHF remain unclear in patients with acute myocardial infarction (AMI). A total of 9561 AMI patients with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 were enrolled from a large nationwide cohort. RHF was defined as eGFR > 90th percentile after multiple adjustments. The primary endpoint was a combination of 3 year major adverse cardiovascular events (MACEs) after AMI treatment. The cumulative event rate of MACEs was significantly higher in patients with RHF. In multivariable Cox-regression analysis, RHF increased the 1.34-fold risk of MACE (95% confidence interval [CI] 1.12–1.62) compared to those without RHF. Patients with RHF had a significantly higher risk of all-cause mortality (hazard ratio [HR] 1.64; 95% CI 1.25–2.14) and cardiac death (HR 1.78; 95% CI 1.26–2.51). There was a U-shaped association between the adjusted risk of MACEs and eGFR, with the risk increasing as eGFR exceeded approximately 100 mL/min/1.73 m2. The results demonstrated a consistent pattern in the 1:1 PS-matched population. Our study offers new insights into the risk stratification of AMI patients with RHF.https://doi.org/10.1038/s41598-025-07768-yRenal hyperfiltrationMajor cardiovascular eventsAcute myocardial infarction
spellingShingle Jin Sug Kim
Weon Kim
Hyo-jin Lee
Kyung Hwan Jeong
Su Jin Jeong
Myung Ho Jeong
Jin-Yong Hwang
Seung Ho Hur
Hyeon Seok Hwang
Renal hyperfiltration as risk factor of major adverse cardiovascular events in patients with acute myocardial infarction
Scientific Reports
Renal hyperfiltration
Major cardiovascular events
Acute myocardial infarction
title Renal hyperfiltration as risk factor of major adverse cardiovascular events in patients with acute myocardial infarction
title_full Renal hyperfiltration as risk factor of major adverse cardiovascular events in patients with acute myocardial infarction
title_fullStr Renal hyperfiltration as risk factor of major adverse cardiovascular events in patients with acute myocardial infarction
title_full_unstemmed Renal hyperfiltration as risk factor of major adverse cardiovascular events in patients with acute myocardial infarction
title_short Renal hyperfiltration as risk factor of major adverse cardiovascular events in patients with acute myocardial infarction
title_sort renal hyperfiltration as risk factor of major adverse cardiovascular events in patients with acute myocardial infarction
topic Renal hyperfiltration
Major cardiovascular events
Acute myocardial infarction
url https://doi.org/10.1038/s41598-025-07768-y
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