Acute myocardial infarction in (chronic) renal insufficiency
Authors:
S. Janoušek
Authors place of work:
LF MU a FN Brno, pracoviště Bohunice
; Interní kardiologická klinika
Published in the journal:
Kardiol Rev Int Med 2007, 9(1): 13-21
Category:
Editorial
Summary
Renal insufficiency (RI) is important negative prognostic factor in acute myocardial infarction (AMI) despite the use of the most modern therapeutic procedure that is nowadays coronary angioplasty. The causes are especially severe diffuse atherosclerotic damage in patient with RI, impaired healing of necrotic lesion because of catabolism, increased cumulation of risk factors (hypertension, diabetes mellitus, and dyslipidaemia) and frequent anemia in renal diseases, and also other metabolic disturbances that significantly accelerated atherosclerosis. Application of contrast media is significantly worse tolerated at impairment of renal function, and leads to enhanced rate of contrast nephropathy, which is connected with higher mortality and other cardiovascular complications. Its prevention is important approach to mortality reduction. The observations from clinic practice also repeatedly prove significantly more frequent incomplete basic pharmacotherapy in patients with RI and AMI, particularly less frequent is administration of beta blockers, acetylsylic acid, statins and ACE inhibitors. The specific problems also arise in patients with RI with drug dosing because of different metabolism and impaired renal elimination.
Key words:
Renal insufficiency, acute myocardial infarction, prognosis, percutaneous coronary angioplasty, contrast nephropathy, pharmacotherapy, drug dosing
Zdroje
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Štítky
Paediatric cardiology Internal medicine Cardiac surgery CardiologyČlánok vyšiel v časopise
Cardiology Review
2007 Číslo 1
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