title: Prognostic value of early acute kidney injury after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction.
abstract: The pattern and prognostic impact of "early" acute kidney injury (AKI) after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction have not been well established. From November 2005 to November 2011, 971 post-myocardial infarction patients who underwent primary PCI were analyzed. Early AKI was defined using absolute change in serum creatinine (SCr; SCr <24 hours after primary PCI minus admission SCr) as follows: no early AKI (SCr change <0.3 mg/dl), mild early AKI (SCr change 0.3 to <0.5 mg/dl), moderate early AKI (SCr change 0.5 to <1.0 mg/dl), and severe early AKI (SCr change ≥1.0 mg/dl). One-year major adverse cardiac events were defined as death, nonfatal myocardial infarction, and revascularizations. Overall, 9.6% had early AKI, including 5.7% with mild, 2.5% with moderate, and 1.4% with severe early AKI. Diabetes mellitus (odds ratio 1.84, p = 0.042), the left ventricular ejection fraction (odds ratio 0.97, p = 0.042), and hemoglobin levels (odds ratio 0.84, p = 0.039) were independently associated with early AKI. Early AKI (adjusted hazard ratio 2.80, p = 0.005) was an independent predictor of 1-year major adverse cardiac events. The adjusted hazard ratios of 1-year major adverse cardiac events from the lowest (reference) to the highest quartile of early AKI were as follows: 1, 2.87 (p = 0.012), 3.22 (p = 0.021), and 5.83 (p = 0.004), respectively. In conclusion, early dynamic change in renal function after primary PCI can sensitively predict worse outcomes.
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea. Electronic address: ljhmh75@chol.com.
authors.forename: Jang Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Se Yong
authors.initials: SY
authors.lastname: Jang
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Myung Hwan
authors.initials: MH
authors.lastname: Bae
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Dong Heon
authors.initials: DH
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Hun Sik
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Yongkeun
authors.initials: Y
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D017023:Coronary Angiography; D003404:Creatinine / Q000097:blood; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000601:surgery*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D003404:Creatinine