title: Impact of contrast-induced acute kidney injury with transient or persistent renal dysfunction on long-term outcomes of patients with acute myocardial infarction undergoing percutaneous coronary intervention.
abstract: OBJECTIVE
  To investigate the long-term prognostic implications of contrast-induced acute kidney injury (CI-AKI) with transient or persistent renal dysfunction in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI).
  
  
  METHODS
  A retrospective observational registry study.
  
  
  METHODS
  Clinical follow-up after PCI. Patients and methods A total of 1041 PCI-treated AMI patients from the Infarction Prognosis Study registry. CI-AKI was defined as an increase in serum creatinine (>25% or >0.5 mg/dl (>44.2 μmol/l)) within 2 days after PCI. Main outcome measures Two-year cumulative event rate of all-cause death or renal failure requiring dialysis.
  
  
  RESULTS
  CI-AKI was observed in 148 patients (14.2%). Patients with CI-AKI had a higher rate of death or dialysis (25.4% vs. 6.3%, p<0.001) at 2 years compared with patients without CI-AKI. CI-AKI was an important independent predictor of death or dialysis (HR 2.76, 95% CI 1.61 to 4.73, p<0.001) Persistent renal dysfunction after CI-AKI was documented in 68 patients (45.9%). Patients with transient renal dysfunction showed a lower 2-year event rate of death or dialysis compared with those with persistent renal dysfunction (17.9% vs. 34.1%, p=0.013); however, they showed a higher event rate compared with those without CI-AKI (17.9% vs. 6.3%, p<0.001).
  
  
  CONCLUSIONS
  Transient and persistent renal dysfunction after CI-AKI was associated with increased short and long-term mortality and morbidity in AMI patients treated by PCI. Better preventive strategies are needed to improve clinical outcomes in AMI patients at high risk of developing CI-AKI.
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors: Jin
authors: J
authors: Wi
authors: Young-Guk
authors: YG
authors: Ko
authors: Jung-Sun
authors: JS
authors: Kim
authors: Byeong-Keuk
authors: BK
authors: Kim
authors: Donghoon
authors: D
authors: Choi
authors: Jong-Won
authors: JW
authors: Ha
authors: Myeong-Ki
authors: MK
authors: Hong
authors: Yangsoo
authors: Y
authors: Jang