title: Blood Transfusion and the Risk of Acute Kidney Injury Among Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.
abstract: Acute kidney injury (AKI) complicating percutaneous coronary intervention (PCI) is associated with adverse clinical outcomes. To date, no studies have evaluated the association of blood transfusion with AKI in patients undergoing PCI.
  
  
  
  We used a retrospective cohort study of all patients with acute coronary syndrome undergoing PCI from CathPCI Registry (n=1 756 864). The primary outcome was AKI defined as the rise in serum creatinine post procedure ≥0.5 mg/dL or ≥25% above baseline values. AKI developed in 9.0% of study sample. Patients with AKI were older, more often women, and had high prevalence of comorbidities, including diabetes mellitus, hypertension, and advanced stages of chronic kidney disease at baseline. Blood transfusion was utilized in 2.2% of patients. In the overall sample, AKI developed in 35.1% of patients who received transfusion versus 8.4% of patients without transfusion (adjusted odds ratio, 4.87 [4.71-5.04]). In the subgroup of patients who sustained bleeding event and received transfusion, the rate of AKI was significantly increased across all preprocedure hemoglobin levels versus no blood transfusion. Similar findings were seen in the subgroup of patients with no bleeding event.
  
  
  
  Blood transfusion is strongly associated with AKI in patients with acute coronary syndrome undergoing PCI. Further investigation is needed to determine whether a restrictive blood transfusion strategy might improve PCI outcomes by reducing the risk of AKI.
authors: From the Unity Point Clinic-St. Luke's Hospital, Cedar Rapids, IA (W.K.); Duke Clinical Research Institution, Durham, NC (A.N.V., D.D., D.W., S.V.R.); and American University of Beirut, Lebanon (H.D.). wassef@hotmail.com.
authors: Wassef
authors: W
authors: Karrowni
authors: From the Unity Point Clinic-St. Luke's Hospital, Cedar Rapids, IA (W.K.); Duke Clinical Research Institution, Durham, NC (A.N.V., D.D., D.W., S.V.R.); and American University of Beirut, Lebanon (H.D.).
authors: Amit Navin
authors: AN
authors: Vora
authors: From the Unity Point Clinic-St. Luke's Hospital, Cedar Rapids, IA (W.K.); Duke Clinical Research Institution, Durham, NC (A.N.V., D.D., D.W., S.V.R.); and American University of Beirut, Lebanon (H.D.).
authors: David
authors: D
authors: Dai
authors: From the Unity Point Clinic-St. Luke's Hospital, Cedar Rapids, IA (W.K.); Duke Clinical Research Institution, Durham, NC (A.N.V., D.D., D.W., S.V.R.); and American University of Beirut, Lebanon (H.D.).
authors: Daniel
authors: D
authors: Wojdyla
authors: From the Unity Point Clinic-St. Luke's Hospital, Cedar Rapids, IA (W.K.); Duke Clinical Research Institution, Durham, NC (A.N.V., D.D., D.W., S.V.R.); and American University of Beirut, Lebanon (H.D.).
authors: Habib
authors: H
authors: Dakik
authors: From the Unity Point Clinic-St. Luke's Hospital, Cedar Rapids, IA (W.K.); Duke Clinical Research Institution, Durham, NC (A.N.V., D.D., D.W., S.V.R.); and American University of Beirut, Lebanon (H.D.).
authors: Sunil V
authors: SV
authors: Rao
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D000368:Aged; D000740:Anemia / Q000097:blood / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D001803:Blood Transfusion; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006470:Hemorrhage / Q000097:blood / Q000209:etiology / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D057216:Propensity Score; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D065227:Transfusion Reaction / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D016896:Treatment Outcome; D014481:United States; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D003404:Creatinine
keywords: acute kidney injury; blood transfusion; percutaneous coronary intervention; renal insufficiency; retrospective studies