Development of a novel score to predict the risk of acute kidney injury in patient with acute myocardial infarction.
BACKGROUND
Acute kidney injury (AKI) is common in patients with acute myocardial infarction. AKI in this setting is associated with short- and long-term adverse events. The aim of this study was to develop a simple score to predict AKI in patients presenting with acute myocardial infarction based on data available at time of admission.


METHODS
This was a retrospective analysis of data collected as part of the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) registry at a tertiary care center between 1/1/2011 and 12/31/2013. Data were collected prospectively for all patients who presented within 24 h of the onset of myocardial infarction. AKI was defined as an increase in creatinine from admission level to peak level of ≥0.3 mg/dl or by ≥50 %. Patients with history of end-stage renal disease requiring renal replacement therapy were excluded.


RESULTS
Of 1107 patients included in the study, 147 (13.3 %) developed AKI. The following factors were independently associated with increased risk for AKI: cardiac arrest, decompensated heart failure on presentation, diabetes mellitus, hypertension, anemia, impaired renal function on presentation, and tachycardia on presentation. These factors were combined to form a new predictive tool. The new score showed excellent discrimination for AKI: the area under the receiver operating characteristic curve (AUROC) was 0.76 (95 % confidence interval 0.72-0.80).


CONCLUSIONS
A simple score using clinical and laboratory data available on admission can predict the risk of AKI in patients presenting with acute myocardial infarction.
Florida Hospital Internal Medicine Residency Program, 2501 N Orange Ave, Suite 235, Orlando, FL, 32804, USA. Khalid.abusaada.md@flhosp.org.
Khalid
http://orcid.org/0000-0001-8842-7233
K
Abusaada
Florida Hospital Internal Medicine Residency Program, 2501 N Orange Ave, Suite 235, Orlando, FL, 32804, USA.
Cai
C
Yuan
Florida Hospital Internal Medicine Residency Program, 2501 N Orange Ave, Suite 235, Orlando, FL, 32804, USA.
Rafay
R
Sabzwari
Florida Hospital Internal Medicine Residency Program, 2501 N Orange Ave, Suite 235, Orlando, FL, 32804, USA.
Khurram
K
Butt
Florida Hospital Internal Medicine Residency Program, 2501 N Orange Ave, Suite 235, Orlando, FL, 32804, USA.
Aadil
A
Maqsood
D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003404:Creatinine / Q000097:blood; D003661:Decision Support Techniques; D005260:Female; D005919:Glomerular Filtration Rate; D006439:Hemodynamics; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D012372:ROC Curve; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D062606:Tertiary Care Centers
D015415:Biomarkers; D003404:Creatinine
Acute coronary syndrome; Acute kidney injury; Acute myocardial infarction; Incidence