Acute kidney injury during STEMI hospitalization was associated with higher in-hospital mortality (13.19% vs 10.89%, RR 1.211) and 30-day readmission (12.44% vs 12.04%, RR 1.033) than no AKI.
Observational (n=1,799,514)
Yes
Does acute kidney injury increase in-hospital mortality and 30-day readmission in patients with ST-elevation myocardial infarction?
In STEMI patients, acute kidney injury during the index hospitalization is associated with increased in-hospital mortality and 30-day readmissions, emphasizing the importance of early renoprotective strategies.
Effect estimate: RR 1.211 (95% CI 1.20-1.22)
Absolute Event Rate: 13.19% vs 10.89%
Background: AKI frequently complicates STEMI hospitalizations and may significantly impact short-term outcomes of readmission and mortality.Prior studies have established AKI as a prognostic marker in acute coronary syndromes, yet the differential effects on immediate versus post-discharge outcomes remain incompletely characterized.We analyzed national trends in STEMI patients and evaluated its impact on 30-day readmissions.Methods: The 2019-2021 NRD was queried for STEMI hospitalizations.We compared those with AKI during index hospitalization to those without AKI.A propensity score for AKI was constructed using survey-weighted logistic regression incorporating demographics, payer status, hospital characteristics, MI subtypes (AWMI, IWMI), and baseline comorbidities (CKD, HTN, DM, CHF, COPD, obesity, CAD, Afib, PVD, CVA).Stabilized inverse probability of treatment weights were combined with discharge weights.Weighted risks and risk ratios were estimated for primary outcomes (in-hospital mortality, 30-day readmission).Covariate balance was assessed via weighted standardized mean differences.Results: Of 1,799,514 weighted STEMI hospitalizations, AKI was significantly associated with higher risk of in-hospital mortality (13.19% vs 10.89%, RR 1.211, 95% CI 1.20-1.22;2.3% absolute increase, 21% relative elevation) when compared to those without AKI.Those with AKI also had higher 30day readmission rates (12.44%vs 12.04%, RR 1.033, 95% CI 1.028-1.045;0.4% absolute difference).Weighted distribution of readmission diagnoses among readmitted patients showed that kidney-related readmissions were higher in those with AKI (13.3% vs 5.8%, P<0.001).Conclusions: In a national sample of STEMI patients, AKI was associated with increased in-hospital mortality, 30-day readmission, and likelihood of readmission for kidney-related diagnoses.These findings support the need for early renoprotective intervention in STEMI patients.
Adekeye et al. (2026) conducted an observational in ST-Elevation Myocardial Infarction (n=1,799,514). Acute Kidney Injury vs. No Acute Kidney Injury was evaluated on in-hospital mortality (RR 1.211, 95% CI 1.20-1.22). Acute kidney injury during STEMI hospitalization was associated with higher in-hospital mortality (13.19% vs 10.89%, RR 1.211) and 30-day readmission (12.44% vs 12.04%, RR 1.033) than no AKI.