Impact of Acute kidney Injury on In-hospital Outcome of Patients with First Attack of Acute Myocardial Infarction

Q: What are the key findings of this study?

Acute kidney injury in patients with first-attack acute myocardial infarction was significantly associated with higher in-hospital heart failure (92.8% vs 11.2%, p<0.001) and mortality (9.3% vs 1.6%).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: First attack of Acute Myocardial Infarction (AMI) (n=401). Intervention: Acute Kidney Injury (AKI) vs. Non-AKI (serum creatinine increase <0.3 mg/dL). Primary outcome: In-hospital heart failure (r=0.640, p=<0.001).

Q: What does this research mean for the field?

Acute kidney injury in patients with a first attack of acute myocardial infarction is significantly associated with increased in-hospital heart failure (92.8% vs 11.2%) and mortality (9.3% vs 1.6%). Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the association between acute kidney injury and in-hospital heart failure, arrhythmia, cardiogenic shock, and mortality among patients admitted with a first attack of acute myocardial infarction.

Anupam Kanti Thakur; Mirza Md Nazrul Islam; S M Sharif Uddin Pathan; Mohammad Abdus Sattar Bhuiyan; Ruhul Amin; Md Sharif Hasan; Md Zunaid Hasan; Jahir Uddin Mohammed Sharif; Islam Ms; Sayed Mainuddin Ahmed; Haripada Roy; Abu Md. Towab; Joydeep Goswami

doi:10.70818/jnmc.v03i02.0114

November 1, 2026Journal of Netrokona Medical CollegeOpen Access

Impact of Acute kidney Injury on In-hospital Outcome of Patients with First Attack of Acute Myocardial Infarction

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Key result

AKI in first-attack AMI linked to ~8-fold higher in-hospital heart failure.

r=0.640
P<0.001
n=401

Why the study?

Acute kidney injury is a frequent complication of acute myocardial infarction associated with adverse outcomes, prompting evaluation of its association with in-hospital heart failure, arrhythmia, cardiogenic shock, and mortality in patients with a first attack of AMI.

Key Points

To evaluate the association between acute kidney injury and in-hospital heart failure, arrhythmia, cardiogenic shock, and mortality among patients admitted with a first attack of acute myocardial infarction.
Cross-sectional observational study conducted from August 2017 to October 2018 in the Department of Cardiology at Mymensingh Medical College Hospital.
Enrolled 401 patients with first-attack acute myocardial infarction, divided into acute kidney injury (n=97) and non-acute kidney injury (n=304) cohorts.
Diagnosed acute kidney injury using serum creatinine measurements taken on hospital admission and after 48 hours, followed by tracking of major in-hospital cardiac events.
Acute kidney injury developed in 24.2% of patients (80.41% stage 1, 12.37% stage 2, and 7.22% stage 3); affected patients were older (mean age 60.08±12.48 vs. 52.27±11.90 years, p<0.001) and had higher rates of hypertension (37.1% vs. 21.4%, p<0.001).
Heart failure (92.8% vs. 11.2%), cardiogenic shock (9.3% vs. 1.6%), arrhythmia (11.3% vs. 2.6%), and in-hospital mortality (9.3% vs. 1.6%) were significantly higher in the acute kidney injury group than in the non-acute kidney injury group (all p<0.001).
Acute kidney injury correlated significantly and positively with heart failure (r=0.640), age (r=0.232), death (r=0.171), arrhythmia (r=0.157), cardiogenic shock (r=0.149), and hypertension (r=0.114).

Study Design

Type

Cross-Sectional (n=401)

Multicenter

No

Structured PICO

P

Population

401 predominantly male patients (mean age ~54 years, 13.2% female) hospitalized with a first attack of acute myocardial infarction in Bangladesh, excluding those referred for primary PCI or with chronic kidney disease, followed during their hospital stay (~4.4 days).

O

Outcome

In-hospital major cardiac events: heart failure, cardiogenic shock, arrhythmia, and mortality during hospitalizationhard clinical

Main Result

Effect estimate: r=0.640

Absolute Event Rate: 92.8% vs 11.2%

p-value: p=<0.001

In patients presenting with a first acute myocardial infarction, the development of acute kidney injury is common (24.2%) and strongly associated with markedly higher rates of in-hospital heart failure, cardiogenic shock, arrhythmia, and death.

Limitations

Single-center cross-sectional design with purposive sampling
Patients referred for primary PCI or who died immediately after admission were excluded

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Implication

AKI in AMI signals high in-hospital mortality risk; extends prior associations but remains hypothesis-generating for interventions.

Abstract

Background: Acute kidney injury (AKI) is a frequent complication of acute myocardial infarction (AMI) and is associated with adverse clinical outcomes. Objective: This study evaluated the association between AKI and in-hospital heart failure, arrhythmia, cardiogenic shock, and mortality in patients with a first attack of AMI. Methods: This cross-sectional observational study was conducted in the Department of Cardiology, Mymensingh Medical College Hospital, from August 2017 to October 2018. A total of 401 patients with first-attack AMI were enrolled and divided into AKI and non-AKI groups. Serum creatinine was measured on admission and after 48 hours to diagnose AKI. In-hospital major cardiac events were recorded and analyzed. Results: AKI occurred in 24.2% of patients. The mean age was higher in the AKI group than in the non-AKI group (60.08±12.48 vs. 52.27±11.90 years). Hypertension was significantly more common among patients with AKI (37.1% vs. 21.4%, p\<0.001). Heart failure (92.8% vs. 11.2%), cardiogenic shock (9.3% vs. 1.6%), arrhythmia (11.3% vs. 2.6%), and mortality (9.3% vs. 1.6%) were significantly higher in the AKI group (p\<0.001). AKI showed significant positive correlations with age (r=0.232), heart failure (r=0.640), cardiogenic shock (r=0.149), arrhythmia (r=0.157), and death (r=0.171). Hypertension was also positively correlated with AKI (r=0.114), while smoking showed a weak correlation (r=0.087). Conclusion: AKI in patients with first-attack AMI is significantly associated with adverse in-hospital outcomes, including heart failure, cardiogenic shock, arrhythmia, and mortality.

Discussion

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Cite This Study

Thakur et al. (2026) conducted a cross-sectional in First attack of Acute Myocardial Infarction (AMI) (n=401). Acute Kidney Injury (AKI) vs. Non-AKI (serum creatinine increase <0.3 mg/dL) was evaluated on In-hospital heart failure (r=0.640, p=<0.001). Acute kidney injury in patients with first-attack acute myocardial infarction was significantly associated with higher in-hospital heart failure (92.8% vs 11.2%, p<0.001) and mortality (9.3% vs 1.6%).

synapsesocial.com/papers/6ae92596a8a6b2adf62f6058 https://doi.org/10.70818/jnmc.v03i02.0114

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Impact of Acute kidney Injury on In-hospital Outcome of Patients with First Attack of Acute Myocardial Infarction

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Impact of Acute kidney Injury on In-hospital Outcome of Patients with First Attack of Acute Myocardial Infarction

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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