Abstract: Objective: The aim of this study was to evaluate the efficacy of continuous renal replacement therapy (CRRT) for patients with cardiac insufficiency in conjunction with hypotension after acute myocardial infarction (AMI). Method: We collected patients who had AMI in our hospital from June 2008 to December 2011. After primary percutaneous coronary intervention (PCI), 92 patients presented with cardiac insufficiency, hypotension, and acute left heart failure. All heart failure patients received routine internal treatment at first, and were randomly divided into two groups. One in which patients continued medications and another in which patients applied CRRT. Result: The cardiac function of 46 patients who received standard drug therapy gradually improved. However, compared with the CRRT group, the improvement was slow. In the 46 patients who received CRRT, 2 cases stopped CRRT due to progressive decrease of platelets. One patient with systolic blood pressure lower than 90 mmHg, clinical manifestations of organ hypoperfusion, poor peripheral circulation, cool clammy skin and oliguria, terminated CRRT. Vital signs of the 43 patients who underwent CRRT were stable. The symptoms of heart failure were significantly relieved. After CRRT, the serum electrolytes significantly improved. A week after, left ventricular ejection fraction (LVEF) also improved. The differences of the two groups in one month mortality, mean time with intensive care and mean hospital stay were significant. The numbers of patients with recurrent heart failure during one year follow-up were also significantly different. Conclusion: CRRT is a relatively safe and effective strategy for patients with cardiac insufficiency and hypotension after AMI.

Key words: acute myocardial infarction, acute cardiac insufficiency, hypotension, continuous renal replacement therapy