title: Prognostic Impact of Combined Contrast-Induced Acute Kidney Injury and Hypoxic Liver Injury in Patients with ST Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: Results from INTERSTELLAR Registry.
abstract: BACKGROUND
  Besides contrast-induced acute kidney injury(CI-AKI), adscititious vital organ damage such as hypoxic liver injury(HLI) may affect the survival in patients with ST-elevation myocardial infarction (STEMI). We sought to evaluate the prognostic impact of CI-AKI and HLI in STEMI patients who underwent primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  A total of 668 consecutive patients (77.2% male, mean age 61.3±13.3 years) from the INTERSTELLAR STEMI registry who underwent primary PCI were analyzed. CI-AKI was defined as an increase of ≥0.5 mg/dL in serum creatinine level or 25% relative increase, within 48h after the index procedure. HLI was defined as ≥2-fold increase in serum aspartate transaminase above the upper normal limit on admission. Patients were divided into four groups according to their CI-AKI and HLI states. Major adverse cardiovascular and cerebrovascular events (MACCE) defined as a composite of all-cause mortality, non-fatal MI, non-fatal stroke, ischemia-driven target lesion revascularization and target vessel revascularization were recorded.
  
  
  RESULTS
  Over a mean follow-up period of 2.2±1.6 years, 94 MACCEs occurred with an event rate of 14.1%. The rates of MACCE and all-cause mortality were 9.7% and 5.2%, respectively, in the no organ damage group; 21.3% and 21.3% in CI-AKI group; 18.5% and 14.6% in HLI group; and 57.7% and 50.0% in combined CI-AKI and HLI group. Survival probability plots of composite MACCE and all-cause mortality revealed that the combined CI-AKI and HLI group was associated with the worst prognosis (p<0.0001 for both).
  
  
  CONCLUSIONS
  Combined CI-AKI after index procedure and HLI on admission is associated with poor clinical outcomes in patients with STEMI who underwent primary PCI. (INTERSTELLAR ClinicalTrials.gov number, NCT02800421.).
authors.affiliation: Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: Sang-Don
authors.initials: SD
authors.lastname: Park
authors.affiliation: Department of Cardiology, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
authors.forename: Jeonggeun
authors.initials: J
authors.lastname: Moon
authors.affiliation: Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: Sung Woo
authors.identifier: http://orcid.org/0000-0002-0679-1523
authors.initials: SW
authors.lastname: Kwon
authors.affiliation: Department of Biomedical Sciences, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Young Ju
authors.initials: YJ
authors.lastname: Suh
authors.affiliation: Department of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Ho-Jun
authors.initials: HJ
authors.lastname: Jang
authors.affiliation: Department of Cardiology, Soon Chun Hyang University Bucheon Hospital, Bucheon, Republic of Korea.
authors.forename: Jon
authors.initials: J
authors.lastname: Suh
authors.affiliation: Department of Cardiology, Soon Chun Hyang University Bucheon Hospital, Bucheon, Republic of Korea.
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Park
authors.affiliation: Department of Cardiology, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
authors.forename: Pyung Chun
authors.initials: PC
authors.lastname: Oh
authors.affiliation: Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: Sung-Hee
authors.initials: SH
authors.lastname: Shin
authors.affiliation: Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: Seong-Il
authors.initials: SI
authors.lastname: Woo
authors.affiliation: Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: Dae-Hyeok
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: Jun
authors.initials: J
authors.lastname: Kwan
authors.affiliation: Department of Cardiology, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
authors.forename: WoongChol
authors.initials: W
authors.lastname: Kang
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D000368:Aged; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D008107:Liver Diseases / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D011379:Prognosis; D016016:Proportional Hazards Models; D000072657:ST Elevation Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016019:Survival Analysis