Key result
Persistent renal dysfunction after primary PCI for acute myocardial infarction was a significant risk factor for 3-year mortality (HR 4.99; 95% CI 2.30-10.8; P<0.001).
Why the study?
The long-term prognosis of acute myocardial infarction patients who develop persistent renal dysfunction after contrast-induced nephropathy remains unclear.
Does persistent renal dysfunction after contrast-induced nephropathy increase long-term mortality in patients undergoing primary PCI for acute myocardial infarction?
Cohort (n=952)
Does persistent renal dysfunction after contrast-induced nephropathy increase long-term mortality in patients undergoing primary PCI for acute myocardial infarction?
Persistent, but not transient, renal dysfunction after contrast-induced nephropathy following primary PCI is strongly associated with increased long-term mortality, and can be predicted by a contrast volume to baseline eGFR ratio >3.45.
Answers are grounded in this paper and cite their sources.
May support closer renal surveillance after primary PCI; leaves open whether targeted interventions improve survival.
Background The long‐term prognosis of patients with acute myocardial infarction who develop persistent renal dysfunction ( RD ) remains unclear. We investigated risk factors and prognostic implications of persistent RD after contrast‐induced nephropathy ( CIN ) in patients with acute myocardial infarction after primary percutaneous coronary intervention. Methods and Results We enrolled 952 consecutive patients who underwent primary percutaneous coronary intervention for acute myocardial infarction. CIN was defined as an increase in serum creatinine levels ≥0.5 mg/dL or ≥25% from baseline within 72 hours after percutaneous coronary intervention. Persistent RD was defined as residual impairment of renal function over 2 weeks, and transient RD was defined as recovery of renal function within 2 weeks, after CIN . The overall incidence of CIN was 8.8% and that of persistent CIN was 3.1%. A receiver‐operator characteristic curve showed that the optimal cutoff value of the contrast volume/baseline estimated glomerular filtration rate ratio for persistent CIN was 3.45. In multivariable logistic analysis, a contrast volume/baseline estimated glomerular filtration rate >3.45 was an independent correlate of persistent RD . At 3 years, the incidence of death was significantly higher in patients with persistent RD than in those with transient RD ( P =0.001) and in those without CIN ( P <0.001). Cox regression analysis showed that persistent RD (hazard ratio, 4.99; 95% CI, 2.30–10.8; P <0.001) was a significant risk factor for mortality. A similar trend was observed for the combined end points, which included mortality, hemodialysis, stroke, and acute myocardial infarction. Conclusions Persistent RD , but not transient RD , is independently associated with long‐term mortality. A contrast volume/baseline estimated glomerular filtration rate >3.45 is an independent predictor of persistent RD .
No takes yet. Share an insight, caveat, or question.
Kurogi et al. (2019) conducted a cohort in Acute myocardial infarction (n=952). Persistent renal dysfunction vs. Transient renal dysfunction or no contrast-induced nephropathy was evaluated on Mortality (HR 4.99, 95% CI 2.30-10.8, p=<0.001). Persistent renal dysfunction after primary PCI for acute myocardial infarction was a significant risk factor for 3-year mortality (HR 4.99; 95% CI 2.30-10.8; P<0.001).
Synapse has enriched 10 related papers. Consider them for comparative context: