Key result
Acute kidney injury following acute myocardial infarction was associated with significantly higher in-hospital mortality compared to patients without AKI (15% vs. 2.5%, p < 0.001).
Why the study?
Post-AMI AKI epidemiology and its associated factors are not well understood in the modern age of interventional cardiology.
Cohort (n=1,299)
No
Absolute Event Rate: 15% vs 2.5%
p-value: p=< 0.001
Acute kidney injury remains a frequent complication of acute myocardial infarction (16.4% incidence) and is strongly associated with increased in-hospital mortality and the need for hemodialysis.
AKI post-AMI signals persistent risk in high-Killip or advanced-stage cases; leaves open whether targeted prevention alters outcomes in the PCI era.
Background: Historically, acute kidney injury (AKI) has been a common severe complication of acute myocardial infarction (MI). As percutaneous coronary interventions have become more widely used, AMI outcomes have significantly improved. However, post-AMI AKI epidemiology and its associated factors are not well-understood in the age of interventional cardiology. Materials and methods: This is a retrospective study examining changes in creatinine levels in all patients admitted for AMI in a single medical center between August 2009 and February 2019. KDIGO criteria were used to define the different stages of post-AMI AKI. Results: The study included 1299 eligible cases, among which 213 (16.4%) developed AKI during AMI index admission; and 128 (60.1%), 46 (21.6%), and 39 (18.3%) were classified as KDIGO stages 1, 2, and 3, respectively. Compared with non-AKI subjects, the AKI group had a higher prevalence of non-STEMI (48.4% vs. 29.1%, p < 0.001), higher Killip class (3 or 4), and higher in-hospital mortality (15% vs. 2.5%, p < 0.001). During the index MI hospitalization, 13.6% (29/213) of the post-MI AKI patients received hemodialysis. Baseline abnormal creatinine (≥1.5 mg/dL), dyslipidemia, and more advanced KDIGO stages (2 or 3) were associated with an increased risk of requiring in-hospital hemodialysis. Moreover, a more advanced KDIGO stage (≥2) was correlated with higher all-cause in-hospital mortality. Conclusion: AMI patients remain at risk of AKI, which negatively affects their survival in the modern age.
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Wang et al. (2022) conducted a cohort in Acute Myocardial Infarction (n=1,299). Acute kidney injury vs. No acute kidney injury was evaluated on In-hospital mortality (p=< 0.001). Acute kidney injury following acute myocardial infarction was associated with significantly higher in-hospital mortality compared to patients without AKI (15% vs. 2.5%, p < 0.001).
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