Accreditation drives teaching: evidence-based medicine and medical education standards

Objective To investigate the long-term prognostic implications of contrast-induced acute kidney injury (CI-AKI) with transient or persistent renal dysfunction in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI). Design A retrospective observational registry study. Setting Clinical follow-up after PCI. Patients and Methods A total of 1041 PCI-treated AMI patients from the Infarction Prognosis Study registry. CI-AKI was defined as an increase in serum creatinine (>25% or >0.5 mg/dl (>44.2 μmol/l)) within 2 days after PCI. Main Outcome Measures Two-year cumulative event rate of all-cause death or renal failure requiring dialysis. Results CI-AKI was observed in 148 patients (14.2%). Patients with CI-AKI had a higher rate of death or dialysis (25.4% vs 6.3%, pConclusion Transient and persistent renal dysfunction after CI-AKI was associated with increased short and long-term mortality and morbidity in AMI patients treated by PCI. Better preventive strategies are needed to improve clinical outcomes in AMI patients at high risk of developing CI-AKI.