Female gender was not independently associated with acute kidney injury in STEMI patients undergoing PCI after adjusting for baseline characteristics (adjusted OR 1.01; 95% CI 0.73-1.4; p=0.94).
Cohort (n=2,967)
Does female gender increase the risk of AKI in STEMI patients undergoing PCI?
While females have higher unadjusted rates of AKI post-PCI for STEMI, this difference is driven by baseline comorbidities rather than gender itself.
Odds Ratio: 1.01 (95% CI 0.73–1.4)
Absolute Event Rate: 12.7% vs 7.8%
p-value: p=0.94
Patients undergoing percutaneous coronary interventions (PCIs) are prone to a wide range of complications; one complication that is constantly correlated with a worse prognosis is acute kidney injury (AKI). Gender as an independent risk factor for said complications has raised some interest; however, studies have shown conflicting results so far. We aimed to investigate the possible relation of gender to the occurrence of AKI in STEMI patients undergoing PCI. This retrospective observational study cohort included 2967 consecutive patients admitted with STEMI between the years 2008 and 2019. Their renal outcomes were assessed according to KDIGO criteria (AKI serum creatinine ≥ 0.3 mg/dL from baseline within 48 h from admission), and in-hospital complications and mortality were reviewed. Our main results show that female patients were older (69 vs. 60, p < 0.001) and had higher rates of diabetes (29.2% vs. 23%, p < 0.001), hypertension (62.9% vs. 41.3%, p < 0.001), and chronic kidney disease (26.7% vs. 19.3%, p < 0.001). Females also had a higher rate of AKI (12.7% vs. 7.8%, p < 0.001), and among patients with AKI, severe AKI was also more prevalent in females (26.1% vs. 14.5%, p = 0.03). However, in multivariate analyses, after adjusting for the baseline characteristics above, the female gender was a non-significant predictor for AKI (adjusted OR 1.01, 95% CI 0.73−1.4, p = 0.94) or severe AKI (adjusted OR 1.65, 95% CI 0.80−1.65, p = 0.18). In conclusion, while females had higher rates of AKI and severe AKI, gender was not independently associated with AKI after adjusting for other confounding variables. Other comorbidities that are more prevalent in females can account for the difference in AKI between genders.
Frydman et al. (Sat,) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=2,967). Female gender vs. Male gender was evaluated on Occurrence of acute kidney injury (AKI serum creatinine ≥ 0.3 mg/dL from baseline within 48 h from admission) (adjusted OR 1.01, 95% CI 0.73-1.4, p=0.94). Female gender was not independently associated with acute kidney injury in STEMI patients undergoing PCI after adjusting for baseline characteristics (adjusted OR 1.01; 95% CI 0.73-1.4; p=0.94).