title: Association of admission hemoglobin levels and acute kidney injury among myocardial infarction patients treated with primary percutaneous intervention.
abstract: BACKGROUND
  Anemia on admission is associated with an increased risk for contrast-induced nephropathy, however, its association with acute kidney injury (AKI) after ST segment elevation myocardial infarction (STEMI) in patients undergoing primary percutaneous coronary intervention (PPCI) has not been studied. Our aim was to evaluate whether admission hemoglobin levels might increase the risk of AKI among STEMI patients who undergo PPCI.
  
  
  METHODS
  We performed a retrospective analysis of 1248 consecutive patients admitted with the diagnosis of STEMI between January 2008 and January 2014, and treated with PPCI. Patient medical records were reviewed for admission hemoglobin levels and for the occurrence of AKI.
  
  
  RESULTS
  The mean age of patients was 61 ± 13 years and 1009 (81%) were male. AKI occurred in 115 patients (9.2%). Patients with AKI were more likely to be older, female, with more comorbidities, had longer symptom duration, and more likely to be in a critical state. Patients with AKI had significantly lower admission hemoglobin levels (13.6 ± 1.7 g/dL vs 14.4 ± 1.5 g/dL; P < 0.001) and were more likely to be anemic (27% vs 12%; P < 0.001). In a multivariate logistic regression model, a lower admission hemoglobin level (odds ratio, 0.86; 95% confidence interval, 0.74-0.98; P = 0.04) and the presence of anemia on admission (odds ratio, 1.76; 95% confidence interval, 1.02-3.02; P = 0.04) emerged as independent predictors of AKI.
  
  
  CONCLUSIONS
  Among STEMI patients who underwent PPCI, a lower admission level of hemoglobin and anemia (hemoglobin < 12 in women or < 13 in men) were independent predictors of AKI. Precautions to prevent AKI should be particularly considered in anemic patients.
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: kobyshacham@gmail.com.
authors.forename: Yacov
authors.initials: Y
authors.lastname: Shacham
authors.affiliation: Department of Nephrology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Gal-Oz
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 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, Tel-Aviv, Israel.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Arbel
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Nir
authors.initials: N
authors.lastname: Flint
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 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, 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, Tel-Aviv, Israel.
authors.forename: Arie
authors.initials: A
authors.lastname: Steinvil
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000601:surgery; D010343:Patient Admission; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D006454:Hemoglobins