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Clinical Research in Cardiology

Erschienen in:

01.07.2014 | Original Paper

Renal impairment according to acute kidney injury network criteria among ST elevation myocardial infarction patients undergoing primary percutaneous intervention: a retrospective observational study

verfasst von: Yacov Shacham, Eran Leshem-Rubinow, Arie Steinvil, Eyal Ben Assa, Gad Keren, Arie Roth, Yaron Arbel

Erschienen in: Clinical Research in Cardiology | Ausgabe 7/2014

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Abstract

Objective

Conflicting data exists regarding the frequency and significance of acute kidney injury (AKI) in ST segment elevation MI (STEMI) patients. The acute kidney injury network (AKIN) classification has been shown to predict mortality in various critically ill patients; however, limited information is available regarding its use and its clinical relevance among STEMI patients.

Study design and methods

We retrospectively studied 1,033 STEMI patients undergoing primary percutaneous intervention (PCI). AKI was identified on the basis of the changes in serum creatinine during hospitalization according to the AKIN criteria. Patients were assessed for in-hospital adverse outcomes as well as all-cause mortality up to 5 years.

Results

Overall, 100 patients (9.6 %) developed AKI: 79 patients (79 %) had stage 1, 14 patients (14 %) developed stage 2, and 7 patients (7 %) developed stage 3 AKI. Patients with AKI had more complications during hospitalization, with higher 30 days (11 vs 1 %; p < 0.001) and 5-year all-cause mortality (29 vs 6 %; p < 0.001) compared to those without AKI. The adjusted risk of death increased proportionally to AKI severity. Compared to patients with no AKI, the adjusted hazard ratio for all-cause mortality was 6.68 (95 % confidence interval: 2.1–21.6, p = 0.002) in patients with AKI. Age, hypertension, chronic kidney injury and low left ventricular ejection fraction were independent predictors of developing AKI.

Conclusion

In STEMI patients undergoing primary PCI, AKI assessed by AKIN criteria is a frequent complication, associated with an increased risk of both short- and long-term mortality.

Goldberg A, Hammerman H, Petcherski S, Zdorovyak A, Yalonetsky S, Kapeliovich M, Agmon Y, Markiewicz W, Aronson D (2005) Inhospital and 1-year mortality of patients who develop worsening renal function following acute ST-elevation myocardial infarction. Am Heart J 150(2):330–337. doi:10.1016/j.ahj.2004.09.055 PubMedCrossRef

Parikh CR, Coca SG, Wang Y, Masoudi FA, Krumholz HM (2008) Long-term prognosis of acute kidney injury after acute myocardial infarction. Arch Intern Med 168(9):987–995. doi:10.1001/archinte.168.9.987 PubMedCrossRef

Marenzi G, Assanelli E, Campodonico J, De Metrio M, Lauri G, Marana I, Moltrasio M, Rubino M, Veglia F, Montorsi P, Bartorelli AL (2010) Acute kidney injury in ST-segment elevation acute myocardial infarction complicated by cardiogenic shock at admission. Crit Care Med 38(2):438–444. doi:10.1097/CCM.0b013e3181b9eb3b PubMedCrossRef

Amin AP, Spertus JA, Reid KJ, Lan X, Buchanan DM, Decker C, Masoudi FA (2010) The prognostic importance of worsening renal function during an acute myocardial infarction on long-term mortality. Am Heart J 160(6):1065–1071. doi:10.1016/j.ahj.2010.08.007 PubMedCrossRef

Latchamsetty R, Fang J, Kline-Rogers E, Mukherjee D, Otten RF, LaBounty TM, Emery MS, Eagle KA, Froehlich JB (2007) Prognostic value of transient and sustained increase in in-hospital creatinine on outcomes of patients admitted with acute coronary syndrome. Am J Cardiol 99(7):939–942. doi:10.1016/j.amjcard.2006.10.058 PubMedCrossRef

Levin A, Warnock DG, Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C (2007) Improving outcomes from acute kidney injury: report of an initiative. Am J Kidney Dis 50(1):1–4. doi:10.1053/j.ajkd.2007.05.008 PubMedCrossRef

Bagshaw SM, George C, Dinu I, Bellomo R (2008) A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients. Nephrol Dial Transplant 23(4):1203–1210. doi:10.1093/ndt/gfm744 PubMedCrossRef

Bagshaw SM, George C, Bellomo R (2008) Early acute kidney injury and sepsis: a multicentre evaluation. Crit Care 12(2):R47. doi:10.1186/cc6863 PubMedCentralPubMedCrossRef

Hobson CE, Yavas S, Segal MS, Schold JD, Tribble CG, Layon AJ, Bihorac A (2009) Acute kidney injury is associated with increased long-term mortality after cardiothoracic surgery. Circulation 119(18):2444–2453. doi:10.1161/CIRCULATIONAHA.108.800011 PubMedCrossRef

10.

James MT, Ghali WA, Knudtson ML, Ravani P, Tonelli M, Faris P, Pannu N, Manns BJ, Klarenbach SW, Hemmelgarn BR (2011) Associations between acute kidney injury and cardiovascular and renal outcomes after coronary angiography. Circulation 123(4):409–416. doi:10.1161/CIRCULATIONAHA.110.970160 PubMedCrossRef

11.

O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Ohman EM, Stevenson WG, Yancy CW (2012) 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 61(4):e78–e140. doi:10.1016/j.jacc.2012.11.019 PubMedCrossRef

12.

Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130(6):461–470PubMedCrossRef

13.

Board. NKFNKDOQIKDA (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39(2 Suppl 1):S1–S266

14.

Koreny M, Karth GD, Geppert A, Neunteufl T, Priglinger U, Heinz G, Siostrzonek P (2002) Prognosis of patients who develop acute renal failure during the first 24 hours of cardiogenic shock after myocardial infarction. Am J Med 112(2):115–119PubMedCrossRef

15.

Marenzi G, Assanelli E, Campodonico J, Lauri G, Marana I, De Metrio M, Moltrasio M, Grazi M, Rubino M, Veglia F, Fabbiocchi F, Bartorelli AL (2009) Contrast volume during primary percutaneous coronary intervention and subsequent contrast-induced nephropathy and mortality. Ann Intern Med 150(3):170–177PubMedCrossRef

16.

Marenzi G, De Metrio M, Rubino M, Lauri G, Cavallero A, Assanelli E, Grazi M, Moltrasio M, Marana I, Campodonico J, Discacciati A, Veglia F, Bartorelli AL (2010) Acute hyperglycemia and contrast-induced nephropathy in primary percutaneous coronary intervention. Am Heart J 160(6):1170–1177. doi:10.1016/j.ahj.2010.09.022 PubMedCrossRef

17.

Weisbord SD, Chen H, Stone RA, Kip KE, Fine MJ, Saul MI, Palevsky PM (2006) Associations of increases in serum creatinine with mortality and length of hospital stay after coronary angiography. J Am Soc Nephrol 17(10):2871–2877. doi:10.1681/ASN.2006030301 PubMedCrossRef

18.

Fox CS, Muntner P, Chen AY, Alexander KP, Roe MT, Wiviott SD (2012) Short-term outcomes of acute myocardial infarction in patients with acute kidney injury: a report from the national cardiovascular data registry. Circulation 125(3):497–504. doi:10.1161/CIRCULATIONAHA.111.039909 PubMedCentralPubMedCrossRef

19.

Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P (2004) Acute renal failure—definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 8(4):R204–R212. doi:10.1186/cc2872 PubMedCentralPubMedCrossRef

20.

Srisawat N, Hoste EE, Kellum JA (2010) Modern classification of acute kidney injury. Blood Purif 29(3):300–307. doi:10.1159/000280099 PubMedCrossRef

21.

Palmieri T, Lavrentieva A, Greenhalgh DG (2010) Acute kidney injury in critically ill burn patients. Risk factors, progression and impact on mortality. Burns 36(2):205–211. doi:10.1016/j.burns.2009.08.012 PubMedCrossRef

22.

Moore EM, Bellomo R, Nichol A, Harley N, Macisaac C, Cooper DJ (2010) The incidence of acute kidney injury in patients with traumatic brain injury. Ren Fail 32(9):1060–1065. doi:10.3109/0886022X.2010.510234 PubMedCrossRef

23.

Kundakci A, Pirat A, Komurcu O, Torgay A, Karakayali H, Arslan G, Haberal M (2010) Rifle criteria for acute kidney dysfunction following liver transplantation: incidence and risk factors. Transplant Proc 42(10):4171–4174. doi:10.1016/j.transproceed.2010.09.137 PubMedCrossRef

24.

Hwang SH, Jeong MH, Ahmed K, Kim MC, Cho KH, Lee MG, Ko JS, Park KH, Sim DS, Yoon NS, Yoon HJ, Kim KH, Hong YJ, Park HW, Kim JH, Ahn YK, Cho JG, Park JC, Kang JC (2011) Different clinical outcomes of acute kidney injury according to acute kidney injury network criteria in patients between ST elevation and non-ST elevation myocardial infarction. Int J Cardiol 150(1):99–101. doi:10.1016/j.ijcard.2011.03.039 PubMedCrossRef

25.

Marenzi G, Cabiati A, Bertoli SV, Assanelli E, Marana I, De Metrio M, Rubino M, Moltrasio M, Grazi M, Campodonico J, Milazzo V, Veglia F, Lauri G, Bartorelli AL (2013) Incidence and relevance of acute kidney injury in patients hospitalized with acute coronary syndromes. Am J Cardiol 111(6):816–822. doi:10.1016/j.amjcard.2012.11.046 PubMedCrossRef

26.

Quintavalle C, Fiore D, De Micco F, Visconti G, Focaccio A, Golia B, Ricciardelli B, Donnarumma E, Bianco A, Zabatta MA, Troncone G, Colombo A, Briguori C, Condorelli G (2012) Impact of a high loading dose of atorvastatin on contrast-induced acute kidney injury. Circulation 126(25):3008–3016. doi:10.1161/CIRCULATIONAHA.112.103317 PubMedCrossRef

27.

Zhao JL, Yang YJ, Zhang YH, You SJ, Wu YJ, Gao RL (2008) Effect of statins on contrast-induced nephropathy in patients with acute myocardial infarction treated with primary angioplasty. Int J Cardiol 126(3):435–436. doi:10.1016/j.ijcard.2007.01.123 PubMedCrossRef

28.

Ueda H, Yamada T, Masuda M, Okuyama Y, Morita T, Furukawa Y, Koji T, Iwasaki Y, Okada T, Kawasaki M, Kuramoto Y, Naito T, Fujimoto T, Komuro I, Fukunami M (2011) Prevention of contrast-induced nephropathy by bolus injection of sodium bicarbonate in patients with chronic kidney disease undergoing emergent coronary procedures. Am J Cardiol 107(8):1163–1167. doi:10.1016/j.amjcard.2010.12.012 PubMedCrossRef

29.

Gassanov N, Nia AM, Caglayan E, Er F (2013) Remote ischemic preconditioning and renoprotection: from myth to a novel therapeutic option? J Am Soc Nephrol. doi:10.1681/ASN.2013070708 PubMed

30.

Hausenloy DJ, Candilio L, Laing C, Kunst G, Pepper J, Kolvekar S, Evans R, Robertson S, Knight R, Ariti C, Clayton T, Yellon DM, Investigators ET (2012) Effect of remote ischemic preconditioning on clinical outcomes in patients undergoing coronary artery bypass graft surgery (ERICCA): rationale and study design of a multi-centre randomized double-blinded controlled clinical trial. Clin Res Cardiol 101(5):339–348. doi:10.1007/s00392-011-0397-x PubMedCrossRef

31.

Bell RM, Rear R, Cunningham J, Dawnay A, Yellon DM (2013) Effect of remote ischaemic conditioning on contrast-induced nephropathy in patients undergoing elective coronary angiography (ERICCIN): rationale and study design of a randomised single-centre, double-blind placebo-controlled trial. Clin Res Cardiol. doi:10.1007/s00392-013-0637-3 PubMedCentralPubMed

32.

Er F, Nia AM, Dopp H, Hellmich M, Dahlem KM, Caglayan E, Kubacki T, Benzing T, Erdmann E, Burst V, Gassanov N (2012) Ischemic preconditioning for prevention of contrast medium-induced nephropathy: randomized pilot RenPro Trial (Renal Protection Trial). Circulation 126(3):296–303. doi:10.1161/CIRCULATIONAHA.112.096370 PubMedCrossRef

33.

Botker HE, Kharbanda R, Schmidt MR, Bottcher M, Kaltoft AK, Terkelsen CJ, Munk K, Andersen NH, Hansen TM, Trautner S, Lassen JF, Christiansen EH, Krusell LR, Kristensen SD, Thuesen L, Nielsen SS, Rehling M, Sorensen HT, Redington AN, Nielsen TT (2010) Remote ischaemic conditioning before hospital admission, as a complement to angioplasty, and effect on myocardial salvage in patients with acute myocardial infarction: a randomised trial. Lancet 375(9716):727–734. doi:10.1016/S0140-6736(09)62001-8 PubMedCrossRef

34.

James MT, Samuel SM, Manning MA, Tonelli M, Ghali WA, Faris P, Knudtson ML, Pannu N, Hemmelgarn BR (2013) Contrast-induced acute kidney injury and risk of adverse clinical outcomes after coronary angiography: a systematic review and meta-analysis. Circ Cardiovasc Interv 6(1):37–43. doi:10.1161/CIRCINTERVENTIONS.112.974493 PubMedCrossRef

35.

Gurm HS, Dixon SR, Smith DE, Share D, Lalonde T, Greenbaum A, Moscucci M, Registry BMC (2011) Renal function-based contrast dosing to define safe limits of radiographic contrast media in patients undergoing percutaneous coronary interventions. J Am Coll Cardiol 58(9):907–914. doi:10.1016/j.jacc.2011.05.023 PubMedCrossRef

36.

Tehrani S, Laing C, Yellon DM, Hausenloy DJ (2013) Contrast-induced acute kidney injury following PCI. Eur J Clin Invest 43(5):483–490. doi:10.1111/eci.12061 PubMedCrossRef

37.

Seeliger E, Sendeski M, Rihal CS, Persson PB (2012) Contrast-induced kidney injury: mechanisms, risk factors, and prevention. Eur Heart J 33(16):2007–2015. doi:10.1093/eurheartj/ehr494 PubMedCrossRef

38.

Newby LK, Rutsch WR, Califf RM, Simoons ML, Aylward PE, Armstrong PW, Woodlief LH, Lee KL, Topol EJ, Van de Werf F (1996) Time from symptom onset to treatment and outcomes after thrombolytic therapy. GUSTO-1 Investigators. J Am Coll Cardiol 27(7):1646–1655PubMedCrossRef

39.

Cannon CP, Gibson CM, Lambrew CT, Shoultz DA, Levy D, French WJ, Gore JM, Weaver WD, Rogers WJ, Tiefenbrunn AJ (2000) Relationship of symptom-onset-to-balloon time and door-to-balloon time with mortality in patients undergoing angioplasty for acute myocardial infarction. JAMA, J Am Med Assoc 283(22):2941–2947CrossRef

40.

Bradley EH, Nallamothu BK, Herrin J, Ting HH, Stern AF, Nembhard IM, Yuan CT, Green JC, Kline-Rogers E, Wang Y, Curtis JP, Webster TR, Masoudi FA, Fonarow GC, Brush JE Jr, Krumholz HM (2009) National efforts to improve door-to-balloon time results from the door-to-balloon alliance. J Am Coll Cardiol 54(25):2423–2429. doi:10.1016/j.jacc.2009.11.003 PubMedCrossRef

41.

Reimer KA, Lowe JE, Rasmussen MM, Jennings RB (1977) The wavefront phenomenon of ischemic cell death. 1. Myocardial infarct size vs duration of coronary occlusion in dogs. Circulation 56(5):786–794PubMedCrossRef

42.

Hasche ET, Fernandes C, Freedman SB, Jeremy RW (1995) Relation between ischemia time, infarct size, and left ventricular function in humans. Circulation 92(4):710–719PubMedCrossRef

43.

de Waha S, Eitel I, Desch S, Fuernau G, Lurz P, Haznedar D, Grothoff M, Gutberlet M, Schuler G, Thiele H (2012) Time-dependency, predictors and clinical impact of infarct transmurality assessed by magnetic resonance imaging in patients with ST-elevation myocardial infarction reperfused by primary coronary percutaneous intervention. Clin Res Cardiol 101(3):191–200. doi:10.1007/s00392-011-0380-6 PubMedCrossRef

44.

Shacham Y, Leshem-Rubinow E, Ben-Assa E, Roth A, Steinvil A (2013) Lower admission hemoglobin levels are associated with longer symptom duration in acute ST-elevation myocardial infarction. Clin Cardiol. doi:10.1002/clc.22215 PubMed

Titel: Renal impairment according to acute kidney injury network criteria among ST elevation myocardial infarction patients undergoing primary percutaneous intervention: a retrospective observational study
verfasst von: Yacov Shacham
Eran Leshem-Rubinow
Arie Steinvil
Eyal Ben Assa
Gad Keren
Arie Roth
Yaron Arbel
Publikationsdatum: 01.07.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 7/2014
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-014-0680-8

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