Prognostic impact and predictors of persistent renal dysfunction in acute kidney injury after percutaneous coronary intervention for acute myocardial infarction.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
15 03 2024
Historique:
received: 04 07 2023
accepted: 12 03 2024
medline: 18 3 2024
pubmed: 16 3 2024
entrez: 16 3 2024
Statut: epublish

Résumé

This study aimed to evaluate the prognostic impact and predictors of persistent renal dysfunction in acute kidney injury (AKI) after an emergency percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). A total of 877 patients who underwent emergency PCI for AMI were examined. AKI was defined as serum creatinine (SCr) ≥ 0.3 mg/dL or ≥ 50% from baseline within 48 h after PCI. Persistent AKI was defined as residual impairment of SCr ≥ 0.3 mg/dL or ≥ 50% from baseline 1 month after the procedure. The primary outcome was the composite endpoints of death, myocardial infarction, hospitalization for heart failure, stroke, and dialysis. AKI and persistent AKI were observed in 82 (9.4%) and 25 (2.9%) patients, respectively. Multivariate Cox proportional hazards analysis demonstrated that persistent AKI, but not transient AKI, was an independent predictor of primary outcome (hazard ratio, 4.99; 95% confidence interval, 2.30-10.8; P < 0.001). Age > 75 years, left ventricular ejection fraction < 40%, a high maximum creatinine phosphokinase MB level, and bleeding after PCI were independently associated with persistent AKI. Persistent AKI was independently associated with worse clinical outcomes in patients who underwent emergency PCI for AMI. Advanced age, poor cardiac function, large myocardial necrosis, and bleeding were predictors of persistent AKI.

Identifiants

pubmed: 38491142
doi: 10.1038/s41598-024-56929-y
pii: 10.1038/s41598-024-56929-y
pmc: PMC10943215
doi:

Substances chimiques

Contrast Media 0
Creatinine AYI8EX34EU

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

6299

Informations de copyright

© 2024. The Author(s).

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Auteurs

Takuya Nakamura (T)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Makoto Watanabe (M)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. wmakoto07@kcn.jp.

Junichi Sugiura (J)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Atsushi Kyodo (A)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Saki Nobuta (S)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Kazutaka Nogi (K)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Yasuki Nakada (Y)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Satomi Ishihara (S)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Yukihiro Hashimoto (Y)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Hitoshi Nakagawa (H)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Tomoya Ueda (T)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Ayako Seno (A)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Taku Nishida (T)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Kenji Onoue (K)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Shungo Hikoso (S)

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

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