Arq. Bras. Cardiol. 2025; 122(7): e20250082

Association between Renal Function and the Incidence of Major Adverse Cardiovascular Outcomes 1 Year After the First Acute Myocardial Infarction

Daniel Medeiros Moreira , Marco Antônio de Sousa, Maria Fernanda Scarduelli Cechinel, Roberto Léo da Silva, Tammuz Fattah, Rodrigo de Moura Joaquim

DOI: 10.36660/abc.20250082i

This Original Article is referred by the Short Editorial "Renal Function and Cardiovascular Risk: An Overlooked Prognostic Ally".

Abstract

Background

Cardiovascular diseases are the leading cause of death worldwide, with substantial social and economic impacts. These conditions are frequently associated with comorbidities, including renal dysfunction.

Objectives

To evaluate the association between creatinine clearance and the incidence of cardiovascular outcomes within 1 year in patients diagnosed with acute myocardial infarction (AMI).

Methods

This prospective cohort study included patients hospitalized for their first AMI. Creatinine clearance was assessed in relation to cardiovascular outcomes, including recurrent AMI, stroke, and cardiovascular death. A p-value of <0.05 was considered statistically significant.

Results

A total of 1,324 patients were analyzed, with a mean age of 60.9 ± 11.4 years; 67.4% were male. Creatinine clearance <60 mL/min was significantly associated with systemic arterial hypertension (79.6% vs. 55.1%, p<0.001), diabetes mellitus (40.8% vs. 24.5%, p<0.001), and dyslipidemia (38.8% vs. 31.4%, p=0.043). Higher creatinine clearance values were associated with a reduced risk of major adverse cardiovascular events (MACE) at 1 year (HR: 0.992; 95% CI: 0.984-0.999; p=0.030). Additionally, higher clearance was linked to lower overall mortality (HR: 0.984; 95% CI: 0.970-0.998; p=0.021).

Conclusion

Higher creatinine clearance values are associated with a lower hazard ratio for MACE and overall mortality within 1 year following AMI.