Key result
Acute kidney injury in patients with ST-segment elevation MI increased the risk of death from cardiovascular causes by four times (OR 4.400; 95% CI 1.928-10.040; P<0.001).
Why the study?
The development of acute kidney injury during hospitalization worsens prognosis, but its prognostic value in patients with ST-segment elevation myocardial infarction required evaluation.
Does the development of acute kidney injury increase mortality in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention?
Cohort (n=268)
Does the development of acute kidney injury increase mortality in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention?
Odds Ratio: 4.4 (95% CI 1.928–10.04)
p-value: p=<0.001
Acute kidney injury occurs in approximately 20% of STEMI patients undergoing PCI and is associated with a four-fold increased risk of cardiovascular death at 12 months.
AKI in STEMI signals high CV mortality risk; leaves open whether prevention improves survival.
The development of acute kidney injury (AKI) in patients during hospitalization worsens the prognosis. The study aimed to estimate the prognostic value of AKI in patients with ST-segment elevation myocardial infarction (MI) in prospective follow-up study. A prospective follow-up of 12 months included 268 patients with ST-segment elevation MI who underwent percutaneous coronary intervention. The incidence of AKI was assessed and its effect on the outcome of ST-segment elevation MI during the observed period was traced. AKI was diagnosed according to Kidney Disease: Improving Global Outcomes recommendations. AKI was recorded in 20.5%. The incidence of AKI increased with decrease in the level of glomerular filtration rate on admission (P = 0.047) and an increase in the stage of acute heart failure according to Killip on admission (P = 0.006). The development of AKI was associated with an increase in-hospital mortality, increasing with a worsening stage of AKI (P<0.001), the same pattern was characteristic for death from cardiovascular causes during follow-up. AKI increases the risk of death from cardiovascular causes by four times [odds ratio 95% 4.400 (1.928-10.040), P <0.001]. The multivariate analysis revealed risk factors for the development of AKI: age >75 years (P = 0.006), female (P = 0.008), Killip >I (P = 0.045). AKI is common in patients with ST-segment elevation MI and is associated with a poor prognosis. The development of AKI is associated with an increase mortality, increasing with a worsening stage of AKI.
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Mezhonov et al. (2021) conducted a cohort in ST-segment elevation myocardial infarction (n=268). Acute kidney injury vs. No acute kidney injury was evaluated on Death from cardiovascular causes (OR 4.400, 95% CI 1.928-10.040, p=<0.001). Acute kidney injury in patients with ST-segment elevation MI increased the risk of death from cardiovascular causes by four times (OR 4.400; 95% CI 1.928-10.040; P<0.001).
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