Key result
Acute kidney injury occurred in 7.2% of patients following urgent PCI for ACS and was strongly associated with 1-year mortality (OR 4.33; 95% CI 2.89-6.43).
Why the study?
The predictors, aetiology, and long-term outcomes of acute kidney injury following urgent percutaneous coronary intervention for acute coronary syndrome needed investigation.
What are the incidence, predictors, and 1-year outcomes of acute kidney injury following urgent PCI for acute coronary syndrome?
Cohort (n=2,917)
What are the incidence, predictors, and 1-year outcomes of acute kidney injury following urgent PCI for acute coronary syndrome?
Odds Ratio: 4.33 (95% CI 2.89–6.43)
Acute kidney injury following urgent PCI for ACS occurs in 7.2% of patients and is strongly associated with increased 1-year mortality and need for renal replacement therapy.
AKI after urgent PCI for ACS warrants vigilance; observational data leave open whether prevention reduces mortality.
We investigated the predictors, aetiology and long-term outcomes of acute kidney injury (AKI) following urgent percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Acute kidney injury occurred in 198 (7.2%) of 2917 patients: 14.1% of AKI cases were attributed to cardiogenic shock and 5.1% were classified as atheroembolic renal disease (AERD). Significant risk factors for AKI included age (odds ratio [OR] 1.05, 95% confidence limits [CI] 1.03-1.06), diabetes (OR 1.73, 95% CI 1.20-2.47), hypertension (OR 1.43, 95% CI 1.03-2.00), heart failure (OR 3.01, 95% CI 1.58-5.57), femoral access (OR 1.50, 95% CI 1.03-2.15), cardiogenic shock (OR 2.03, 95% CI 1.19-3.37) and ST-elevation myocardial infarction (STEMI) (OR 3.89, 95% CI 2.80-5.47). One-year mortality after AERD was 44.4% and renal replacement therapy (RRT) requirement 22.2% (compared with mortality 33.3% and RRT requirement 7.4%, respectively, in all other AKI patients). Mortality at 1 year was associated with AKI (OR 4.33, 95% CI 2.89-6.43), age (OR 1.08, 95% CI 1.06-1.09), heart failure (OR 1.92, 95% CI 1.05-3.44), femoral access (OR 2.05, 95% CI 1.41-2.95) and cardiogenic shock (OR 3.63, 95% CI 2.26-5.77). Acute kidney injury after urgent PCI is strongly associated with worse outcomes. Atheroembolic renal disease has a poor outcome and a high likelihood of long-term RRT requirement.
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Carande et al. (2021) conducted a cohort in Acute coronary syndrome (n=2,917). Acute kidney injury vs. No acute kidney injury was evaluated on Mortality at 1 year (OR 4.33, 95% CI 2.89-6.43). Acute kidney injury occurred in 7.2% of patients following urgent PCI for ACS and was strongly associated with 1-year mortality (OR 4.33; 95% CI 2.89-6.43).
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