Acute kidney injury – A frequent and serious complication after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction


Autoři: Abdellatif El-Ahmadi aff001;  Mujahed Sebastian Abassi aff001;  Hedvig Bille Andersson aff001;  Thomas Engstrøm aff001;  Peter Clemmensen aff002;  Steffen Helqvist aff001;  Erik Jørgensen aff001;  Henning Kelbæk aff004;  Frants Pedersen aff001;  Kari Saunamäki aff001;  Jacob Lønborg aff001;  Lene Holmvang aff001
Působiště autorů: Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark aff001;  Department of General and Intervention Cardiology, University Heart Center, Hamburg-Eppendorf, Germany aff002;  Department of Medicine, Division of Cardiology, Nykoebing-Falster Hospital, University of Southern Denmark, Odense, Denmark aff003;  Department of Cardiology, Zealand University Hospital, Denmark aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226625

Souhrn

Objectives

The aim of the study was to investigate the incidence, risk factors and long-term prognosis of acute kidney injury (AKI) in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (primary PCI).

Method

A large-scale, retrospective cohort study based on procedure-related variables, biochemical and mortality data collected between 2009 and 2014 at Rigshospitalet, Copenhagen, Denmark. AKI was defined as an increase in serum creatinine of 25% during the first 72 hours after the index procedure.

Results

A total of 4239 patients were treated with primary PCI of whom 4002 had available creatinine measurements allowing for assessment of AKI and inclusion in this study. The mean creatinine value upon presentation for all patients was 84 μmol/l (standard deviation (SD) ±40) and 97 μmol/l (SD ±53) at peak. AKI occurred in a total of 765 (19.1%) patients. Independent risk factors for the occurrence of AKI were age, time from symptom onset to procedure, peak value of troponin-T, female sex and the contrast volume to eGFR ratio. In a multivariable adjusted analysis AKI was independently associated with a higher mortality rate at 5 years follow-up (hazard ratio 1.39 [95%-confidence interval 1.03–1.88]).

Conclusion

In STEMI patients treated with primary PCI one in five experiences acute kidney injury, which was associated with a substantial increase in both short- and long-term mortality.

Klíčová slova:

Cardiac arrest – Coronary angioplasty – Coronary artery bypass grafting – Creatinine – Death rates – Kidneys – Medical risk factors – Myocardial infarction


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2019 Číslo 12