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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Nature Portfolio
2025-07-01
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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. |
| format | Article |
| id | doaj-art-5e1a49b11ad5421ba3d0803b72cb4c20 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
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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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