title: Impact of point-of-care pre-procedure creatinine and eGFR testing in patients with ST segment elevation myocardial infarction undergoing primary PCI: The pilot STATCREAT study.
abstract: BACKGROUND
  Contrast-induced acute kidney injury (CI-AKI) is a recognised complication during primary PCI that affects short and long term prognosis. The aim of this study was to assess the impact of point-of-care (POC) pre-PPCI creatinine and eGFR testing in STEMI patients.
  
  
  METHODS
  160 STEMI patients (STATCREAT group) with pre-procedure POC testing of Cr and eGFR were compared with 294 consecutive retrospective STEMI patients (control group). Patients were further divided into subjects with or without pre-existing CKD.
  
  
  RESULTS
  The incidence of CI-AKI in the whole population was 14.5% and not different between the two overall groups. For patients with pre-procedure CKD, contrast dose was significantly reduced in the STATCREAT group (124.6ml vs. 152.3ml, p=0.015). The incidence of CI-AKI was 5.9% (n=2) in the STATCREAT group compared with 17.9% (n=10) in the control group (p=0.12). There was no difference in the number of lesions treated (1.118 vs. 1.196, p=0.643) or stents used (1.176 vs. 1.250, p=0.78). For non-CKD patients, there was no significant difference in contrast dose (172.4ml vs. 158.4ml, p=0.067), CI-AKI incidence (16.7% vs. 13.4%, p=0.4), treated lesions (1.167 vs. 1.164, p=1.0) or stents used (1.214 vs. 1.168, p=0.611) between the two groups.
  
  
  CONCLUSIONS
  Pre-PPCI point-of-care renal function testing did not reduce the incidence of CI-AKI in the overall group of STEMI patients. In patients with CKD, contrast dose was significantly reduced, but a numerical reduction in CI-AKI was not found to be statistically significant. No significant differences were found in the non-CKD group.
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom; Post Graduate Medical Institute, Anglia Ruskin University, East of England, United Kingdom.
authors.forename: Grigoris V
authors.initials: GV
authors.lastname: Karamasis
authors.affiliation: Post Graduate Medical Institute, Anglia Ruskin University, East of England, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Hampton-Till
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom.
authors.forename: Firas
authors.initials: F
authors.lastname: Al-Janabi
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom; Post Graduate Medical Institute, Anglia Ruskin University, East of England, United Kingdom.
authors.forename: Shah
authors.initials: S
authors.lastname: Mohdnazri
authors.affiliation: Post Graduate Medical Institute, Anglia Ruskin University, East of England, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Parker
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom.
authors.forename: Adam
authors.initials: A
authors.lastname: Ioannou
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom.
authors.forename: Rohan
authors.initials: R
authors.lastname: Jagathesan
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom.
authors.forename: Alagmir
authors.initials: A
authors.lastname: Kabir
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom.
authors.forename: Jeremy W
authors.initials: JW
authors.lastname: Sayer
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom.
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Robinson
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom.
authors.forename: Rajesh K
authors.initials: RK
authors.lastname: Aggarwal
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom; Post Graduate Medical Institute, Anglia Ruskin University, East of England, United Kingdom.
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Clesham
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom.
authors.forename: Reto A
authors.initials: RA
authors.lastname: Gamma
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Kelly
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom.
authors.forename: Kare H
authors.initials: KH
authors.lastname: Tang
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom; Post Graduate Medical Institute, Anglia Ruskin University, East of England, United Kingdom.
authors.forename: John R
authors.initials: JR
authors.lastname: Davies
authors.affiliation: Department of Cardiology, The Essex Cardiothoracic Centre, Essex, United Kingdom; Post Graduate Medical Institute, Anglia Ruskin University, East of England, United Kingdom. Electronic address: Thomas.keeble@btuh.nhs.uk.
authors.forename: Thomas
authors.initials: T
authors.lastname: Keeble
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D000368:Aged; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood*; D061345:Early Medical Intervention / Q000379:methods; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D010865:Pilot Projects; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000601:surgery*
chemical_list: D003404:Creatinine
keywords: Contrast-induced AKI; Point-of-care testing; Primary PCI; STEMI