title: Acute hyperglycemia and contrast-induced nephropathy in primary percutaneous coronary intervention.
abstract: BACKGROUND
  Acute hyperglycemia and contrast-induced nephropathy (CIN) are frequently observed in ST-elevation acute myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI), and both are associated with an increased mortality rate. We investigated the possible association between acute hyperglycemia and CIN in patients undergoing primary PCI.
  
  
  METHODS
  We prospectively enrolled 780 STEMI patients undergoing primary PCI. For each patient, plasma glucose levels were assessed at hospital admission. Acute hyperglycemia was defined as glucose levels>198 mg/dL (11 mmol/L). Contrast-induced nephropathy was defined as an increase in serum creatinine>25% from baseline in the first 72 hours.
  
  
  RESULTS
  Overall, 148 (19%) patients had acute hyperglycemia; and 113 (14.5%) patients developed CIN. Patients with acute hyperglycemia had a 2-fold higher incidence of CIN than those without acute hyperglycemia (27% vs 12%, P<.001). In-hospital mortality was higher in patients with acute hyperglycemia than in those without acute hyperglycemia (12% vs 3%, P<.001). Mortality rate was also higher in patients developing CIN than in those without this renal complication (27% vs 0.9%, P<.001). Patients with acute hyperglycemia that developed CIN had the highest mortality rate (38%). Acute hyperglycemia was an independent predictor of CIN and in-hospital mortality.
  
  
  CONCLUSIONS
  In STEMI patients undergoing primary PCI, acute hyperglycemia is associated with an increased risk for CIN and with increased in-hospital mortality.
authors.affiliation: Department of Cardiovascular Sciences, Centro Cardiologico Monzino, I.R.C.C.S, University of Milan, Milan, Italy. giancarlo.marenzi@ccfm.it
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Marenzi
authors.forename: Monica
authors.initials: M
authors.lastname: De Metrio
authors.forename: Mara
authors.initials: M
authors.lastname: Rubino
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Lauri
authors.forename: Annalisa
authors.initials: A
authors.lastname: Cavallero
authors.forename: Emilio
authors.initials: E
authors.lastname: Assanelli
authors.forename: Marco
authors.initials: M
authors.lastname: Grazi
authors.forename: Marco
authors.initials: M
authors.lastname: Moltrasio
authors.forename: Ivana
authors.initials: I
authors.lastname: Marana
authors.forename: Jeness
authors.initials: J
authors.lastname: Campodonico
authors.forename: Andrea
authors.initials: A
authors.lastname: Discacciati
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Veglia
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Bartorelli
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D007558:Italy / Q000453:epidemiology; D007674:Kidney Diseases / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends
chemical_list: D003287:Contrast Media