Objective To determine the impact of estimated glomerular filtration rate (eGFR) on short-term (30-day) outcome of the elderly inpatients with acute myocardial infarction (AMI).Methods A total of 327 elderly patients admitted for AMI from January 2001 to December 2007 were divided into the following 4 groups based on their eGFR levels ml/(min·1.73 m2): normal renal function (eGFR≥80),mild renal dysfunction (eGFR 60-90),moderate renal dysfunction,and severe renal dysfunction groups (eGFR<30).The 30-day incidence of cardiac death and cardiac complications (cardiogenic shock,congestive heart failure,or ventricular tachycardia/ventricular fibrillation) were evaluated and the short-term prognostic markers were analyzed.Results The 30-day mortalities were 3.7%,12.1%,23.6%,and 28.6%,respectively,and the incidences of cardiac complications were 15.4%,37.4%,59.7%,and 64.3%,respectively ,in the four groups (P<0.01).Univariate analysis indicated that age,past history of diabetes and stroke,anemia,incipient dyspnea,cardiac complications,and decreased eGFR at admission were significantly associated with the 30-day mortality (P<0.05).Multivariate logistic regression analysis showed that higher 30-day mortality was associated with decreased eGFR (OR 1.60,95%CI 1.08-2.36),age (OR 1.07,95%CI 1.02-1.13),past history of diabetes(OR 3.34,95%CI 1.34-8.34),cardiogenic shock (OR 16.18,95%CI 4.68-55.97),congestive heart failure (OR 5.33,95% CI 2.26-12.56),and ventricular tachycardia or fibrillation (OR 3.99,95%CI 1.29-12.33),respectively.Conclusion A decreased level of eGFR at admission is an independent predictor of short-term mortality in the elderly patients with AMI.