Key result
Acute kidney injury occurred in 19.1% of STEMI patients treated with primary PCI and was independently associated with a higher long-term mortality rate (HR 1.39).
Why the study?
The incidence, risk factors, and long-term prognosis of acute kidney injury in STEMI patients treated with primary PCI needed investigation.
Does acute kidney injury increase long-term mortality in patients with STEMI treated with primary PCI?
Cohort (n=4,002)
No
Does acute kidney injury increase long-term mortality in patients with STEMI treated with primary PCI?
Answers are grounded in this paper and cite their sources.
Acute kidney injury occurs in nearly 20% of STEMI patients undergoing primary PCI and is independently associated with a significant increase in long-term mortality.
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.
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El-Ahmadi et al. (2019) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=4,002). Acute kidney injury vs. No acute kidney injury was evaluated on Long-term all-cause mortality (HR 1.39, 95% CI 1.03-1.88, p=0.033). Acute kidney injury occurred in 19.1% of STEMI patients treated with primary PCI and was independently associated with a higher long-term mortality rate (HR 1.39).
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