title: Analysis of biomarkers for risk of acute kidney injury after primary angioplasty for acute ST-segment elevation myocardial infarction: results of the HORIZONS-AMI trial.
abstract: OBJECTIVE
  Contrast-induced acute kidney injury (CI-AKI) may occur after percutaneous coronary intervention (PCI).
  
  
  METHODS
  We evaluated patients with ST-elevation myocardial infarction (STEMI) undergoing emergency PCI with serial biomarkers.
  
  
  RESULTS
  Of the 390 patients enrolled in the HORIZONS-AMI biomarker substudy, 56 (14.3%) developed AKI. In the AKI group, the levels of B-type natriuretic peptide were consistently higher than in the no-AKI group at baseline (P = 0.0327), hospital discharge (P = 0.0002), 30-day follow-up (P = 0.0193), and 1-year follow-up (P = 0.031). At hospital discharge, the AKI group had elevated biomarkers compared to the no-AKI group: D-dimer (P = 0.0066), C-reactive protein (P = 0.0468), endothelial cell-selective adhesion molecule (P = 0.0169), adiponectin (P = 0.0346), and von Willebrand factor (P = 0.0168); there was also a trend toward higher cystatin C (P = 0.0585) in the AKI group. Similar correlations between biomarker panel increase and the development of CI-AKI were consistent at baseline, 30-day, and 1-year follow-up. Chemokine (C-C motif) ligand 23 showed an opposite pattern with an increase at all time points in the no-AKI compared to the AKI group.
  
  
  CONCLUSIONS
  The risk of CI-AKI after primary PCI for STEMI may be associated with hemostatic imbalances, activation of procoagulants, decreased endogenous anticoagulants, enhanced inflammation, platelet activation, or decreased fibrinolytic activity.
authors.affiliation: Cardiovascular Research Foundation, New York, New York.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Guerchicoff
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.forename: Ke
authors.initials: K
authors.lastname: Xu
authors.forename: Dru
authors.initials: D
authors.lastname: Nichols
authors.forename: Bimmer E
authors.initials: BE
authors.lastname: Claessen
authors.forename: Giulio
authors.initials: G
authors.lastname: Guagliumi
authors.forename: Bernhard
authors.initials: B
authors.lastname: Witzenbichler
authors.forename: José P S
authors.initials: JP
authors.lastname: Henriques
authors.forename: George D
authors.initials: GD
authors.lastname: Dangas
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood*; D001777:Blood Coagulation; D003287:Contrast Media / Q000009:adverse effects; D004630:Emergencies; D005260:Female; D005342:Fibrinolysis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D015539:Platelet Activation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D018836:Inflammation Mediators
keywords: STEMI; acute kidney injury; angioplasty; biomarkers