title: High sensitive C-reactive protein and the risk of acute kidney injury among ST elevation myocardial infarction patients undergoing primary percutaneous intervention.
abstract: BACKGROUND
  Elevated periprocedural high sensitive C-reactive protein (hs-CRP) was shown to be associated with an increased risk for acute kidney injury (AKI) in non-myocardial infarction (MI) patients undergoing percutaneous coronary intervention (PCI), however, no information to date is present regarding its predicting role for AKI in MI patients. We evaluated whether admission serum hs-CRP levels may predict risk of AKI among ST elevation MI (STEMI) patients undergoing primary PCI.
  
  
  METHODS
  Five hundred and sixty-two patients that were admitted with STEMI and treated with primary PCI were included in the study. Serum hs-CRP levels were determined from blood samples taken prior to PCI. Patients' medical records were reviewed for occurrence of AKI, in-hospital complications and 30 days mortality.
  
  
  RESULTS
  Mean age was 62 ± 16 and 455 (80 %) were males. Patients were divided into two groups, according to their admission hs-CRP values: group 1: hs-CRP ≤9 mg/l (n = 394) and group 2: hs-CRP >9 mg/l (n = 168). Patients with hs-CRP >9 mg/l had significantly higher rate of AKI following PCI (17 vs. 6 %; p < 0.001), more in-hospital complications and higher30 -day mortality rate (11 vs. 1 %; p = 0.02). In a multivariable logistic regression model admission hs-CRP level >9 mg/l was an independent predictor for AKI (OR 2.7, 95 % CI: 1.39-5.29; p = 0.001) and a strong trend for 30 day mortality (OR 4.27, 95 % CI: 0.875-21.10; p = 0.07).
  
  
  CONCLUSIONS
  Admission serum hs-CRP level >9 mg/l is an independent predictor for AKI following primary PCI in STEMI patients.
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, 64239, Tel Aviv, Israel. kobyshacham@gmail.com.
authors.forename: Yacov
authors.initials: Y
authors.lastname: Shacham
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, 64239, Tel Aviv, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Leshem-Rubinow
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, 64239, Tel Aviv, Israel.
authors.forename: Arie
authors.initials: A
authors.lastname: Steinvil
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, 64239, Tel Aviv, Israel.
authors.forename: Gad
authors.initials: G
authors.lastname: Keren
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, 64239, Tel Aviv, Israel.
authors.forename: Arie
authors.initials: A
authors.lastname: Roth
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, 64239, Tel Aviv, Israel.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Arbel
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality; D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D002097:C-Reactive Protein / Q000032:analysis*; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007431:Intraoperative Complications / Q000378:metabolism* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000401:mortality; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D011183:Postoperative Complications / Q000378:metabolism* / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Acute kidney injury; Acute myocardial infarction; Biomarkers; C-reactive protein; Inflammation; Percutaneous coronary intervention