Impact of Acute Kidney Injury on Clinical Outcomes after ST Elevation Acute Myocardial Infarction.
10.3349/ymj.2011.52.4.603
- Author:
Min Jee KIM
1
;
Hong Sang CHOI
;
Seul Hyun OH
;
Hyung Chul LEE
;
Chang Seong KIM
;
Joon Seok CHOI
;
Jeong Woo PARK
;
Eun Hui BAE
;
Seong Kwon MA
;
Nam Ho KIM
;
Myung Ho JEONG
;
Soo Wan KIM
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. skimw@chonnam.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Acute kidney injury;
myocardial infarction;
mortality
- MeSH:
Acute Kidney Injury/complications/diagnosis/*epidemiology;
Aged;
Creatinine/blood;
Electrocardiography;
Female;
Humans;
Incidence;
Male;
Middle Aged;
Myocardial Infarction/*complications/diagnosis/mortality;
Prognosis;
Retrospective Studies
- From:Yonsei Medical Journal
2011;52(4):603-609
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study aimed to compare the incidence and clinical significance of transient versus persistent acute kidney injury (AKI) on acute ST elevation myocardial infarction (STEMI). MATERIALS AND METHODS: The study was a retrospective cohort of 855 patients with STEMI. AKI was defined as an increase of > or =0.3 mg/dL in creatinine level at any point during hospital stay. The study population was classified into 5 groups: 1) patients without AKI; 2) patients with mild AKI that was resolved by discharge (creatinine change less than 0.5mg/dL compared with admission creatinine during hospital stay, transient mild AKI); 3) patients with mild AKI that did not resolve by discharge (persistent mild AKI); 4) patients with moderate/severe AKI that was resolved by discharge (creatinine change more than 0.5 mg/dL compared with admission creatinine, transient moderate/severe AKI); 5) patients with moderate/severe AKI that did not resolve by discharge (persistent moderate/severe AKI). We investigated 1-year all-cause mortality after hospital discharge for the primary outcome of the study. The relation between AKI and 1-year mortality after STEMI was analyzed. RESULTS: AKI occurred in 74 (8.7%) patients during hospital stay. Adjusted hazard ratio for mortality was 3.139 (95% CI 0.764 to 12.897, p=0.113) in patients with transient, mild AKI, and 8.885 (95% CI 2.710 to 29.128, p<0.001) in patients with transient, moderate/severe AKI compared to patients without AKI. Persistent moderate/severe AKI was also independent predictor of 1 year mortality (hazard ratio, 5.885; 95% CI 1.079 to 32.101, p=0.041). CONCLUSION: Transient and persistent moderate/severe AKI during acute myocardial infarction is strongly related to 1-year all cause mortality after STEMI.
