035 Analysis of long-term survival after revascularization in patients with chronic kidney disease presenting with ST elevation myocardial infarction

Ischemic heart disease is the most common cause of death in patients with chronic kidney disease (CKD). Patients with CKD who develop an ST elevation myocardial infarction (STEMI) have a poor prognosis, with >70% mortality at 2 years. Despite this heavy burden of disease, the optimal management of ACS in this patient population is unknown. Our goal was to compare the effect of coronary revascularization or medical therapy alone on the long-term survival of patients with CKD presenting with STEMI. From 2005 to 2007, data were prospectively collected on 231 patients admitted to a coronary care unit with the diagnosis of STEMI. Of these, 112 had preserved renal function, and 119 had significant renal dysfunction, as defined by the National Kidney Foundation in the Kidney Disease Outcomes Quality Initiative classification of kidney function as an estimated glomerular filtration rate of