Acute kidney injury and in-hospital mortality in patients with ST-elevation myocardial infarction of different age groups

Cosentino, Nicola; Resta, Marta; Somaschini, Alberto; Campodonico, Jeness; Lucci, Claudia; Moltrasio, Marco; Bonomi, Alice; Cornara, Stefano; Camporotondo, Rita; Demarchi, Andrea; Ferrari, Gaetano Maria De; Bartorelli, Antonio L.; Marenzi, Giancarlo

doi:10.1016/j.ijcard.2021.09.023

Cited by 17 publications

(9 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, the conclusion may have been biased because the objectivity of the results may have been compromised. The retrospective design may miss some characteristics of the patients in the study, such as the evaluation of physical performance and acute kidney injury, which are common in the very elderly cohort (26)(27)(28). These factors might have some influences on the clinical outcomes of PCI treatment (26)(27)(28).…”

Section: Limitationsmentioning

confidence: 99%

“…The retrospective design may miss some characteristics of the patients in the study, such as the evaluation of physical performance and acute kidney injury, which are common in the very elderly cohort (26)(27)(28). These factors might have some influences on the clinical outcomes of PCI treatment (26)(27)(28). In addition, the small sample size is also a constraint, resulting in an 8-year time span for enrolled patients, and the inability to include more stratified variables.…”

Section: Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Sex-related differences in clinical outcomes and predictive factors in the very elderly patients with ACS undergoing PCI

Wang

Guo

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundAs shown in previous studies, there may be sex-related differences in clinical outcomes in patients with acute coronary syndromes (ACS) after percutaneous coronary intervention (PCI). However, the benefits of PCI in very elderly ACS patients and the gender differences were poorly described and understood. We investigated the clinical characteristics and outcomes after PCI by sex stratification, and the predictive factors of major adverse cardiovascular and cerebrovascular events (MACCE) in this very elderly ACS cohort.MethodsA total of 1,676 consecutive ACS patients (50.2% women) aged ≥80 years old between January 2013 and May 2020 were recruited in this study. All patients were divided into four groups according to gender and treatment: male PCI (n = 321) and conservative management groups (n = 513), and female PCI (n = 283) and conservative management groups (n = 559). Clinical and coronary lesion characteristics were compared among four groups, also the clinical outcomes. MACCE and their predictive factors were assessed using Kaplan–Meier curve and Cox regression analysis.ResultsPCI procedures were conducted in 604 patients, and 1,072 were conservative management. Men were most likely to present with prior myocardial infarction (MI), peripheral artery disease, and chronic total occlusion (CTO); women had a higher prevalence of hypertension and dyslipidemia. The proportion of men receiving PCI procedures was significantly higher than that of women (38.5 vs. 33.6%, p = 0.038). Compared to conservative management, successful PCI significantly improved composite MACCE in both men (33.9 vs. 18.4%, p < 0.001) and women (27.9 vs. 20.8%, p = 0.026). There were no differences between sex in the improvement of clinical outcomes after PCI. In addition, age, ST-segment elevation myocardial infarction (STEMI), log N-terminal pro-brain natriuretic peptide (NT-proBNP), P2Y12 receptor antagonist, and β-blocker were independently associated with the incidence of MACCE after PCI tested by the Cox regression model, but not gender (male: hazard ratio (HR) 1.275, 95% confidence interval (CI) 0.853–1.905, p = 0.236).ConclusionIn this very elderly ACS cohort, men presented with more complex clinical conditions, and women were less likely to receive PCI treatment. Both women and men had similar benefits from the PCI procedure in the decrease of MACCE.

show abstract

Section: Limitationsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Sex-related differences in clinical outcomes and predictive factors in the very elderly patients with ACS undergoing PCI

Wang

Guo

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…[1][2][3][4] According to previous research, AKI negatively impacts the short-and long-term prognosis of patients with AMI. [5,6] An earlier study found that even after adjusting for major mortality confounders and AKI predictors, the presence of AKI was significantly associated with a higher risk of in-hospital mortality in patients with AMI receiving primary percutaneous coronary intervention. The nosocomial mortality in patients with AKI was found to be more than 10 times that in patients without AKI.…”

Section: Introductionmentioning

confidence: 99%

“…The nosocomial mortality in patients with AKI was found to be more than 10 times that in patients without AKI. [ 6 ] Another study showed that the 3-year mortality rate in patients with ST-segment elevation myocardial infarction (STEMI) with AKI was 3-fold higher than that in patients without AKI. [ 7 ] It is challenging to recognize AKI before renal function is lost, and kidney damage may be irreversible.…”

Section: Introductionmentioning

confidence: 99%

Predicting AKI in patients with AMI: Development and assessment of a new predictive nomogram

Wang

2023

Medicine

View full text Add to dashboard Cite

Acute kidney injury (AKI) is a common complication of acute myocardial infarction (AMI) and is associated with both longand short-term consequences. This study aimed to investigate relevant risk variables and create a nomogram that predicts the probability of AKI in patients with AMI, so that prophylaxis could be initiated as early as possible. Data were gathered from the medical information mart for the intensive care IV database. We included 1520 patients with AMI who were admitted to the coronary care unit or the cardiac vascular intensive care unit. The primary outcome was AKI during hospitalization. Independent risk factors for AKI were identified by applying least absolute shrinkage and selection operator regression models and multivariate logistic regression analyses. A multivariate logistic regression analysis was used to build a predictive model. The discrimination, calibration, and clinical usefulness of the prediction model were assessed using C-index, calibration plot, and decision curve analysis. Internal validation was assessed using bootstrapping validation. Of 1520 patients, 731 (48.09%) developed AKI during hospitalization. Hemoglobin, estimated glomerular filtration rate, sodium, bicarbonate, total bilirubin, age, heart failure, and diabetes were identified as predictive factors for the nomogram construction (P < .01). The model displayed good discrimination, with a C-index of 0.857 (95% CI:0.807-0.907), and good calibration. A high C-index value of 0.847 could still be reached during interval validation. Decision curve analysis showed that the AKI nomogram was clinically useful when the intervention was determined at an AKI possibility threshold of 10%. The nomogram constructed herein can successfully predict the risk of AKI in patients with AMI early and provide critical information that can facilitate prompt and efficient interventions.

show abstract

“…There are multiple risk factors for AKI development in patients who had acute coronary syndrome (ACS) especially the presence of chronic kidney disease, diabetes mellitus, old age, anemia, and dehydration [ 2 ]. Moreover, systemic hypoperfusion in patients with acute myocardial infarction (AMI) causes renal ischemia secondary to the acute left ventricular systolic failure leading to the development of AKI [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Biomarker array for prediction of acute kidney injury after percutaneous coronary intervention for patients who had acute ST segment elevation myocardial infarction

Alkassas,

Elbarbary,

Sherif

et al. 2023

Heart Vessels

View full text Add to dashboard Cite

Acute kidney injury (AKI) is a common complication after Percutaneous Coronary Intervention (PCI) for ST segment elevation myocardial infarction (STEMI) and is associated with poor outcomes. AKI is diagnosed by the dynamic change of serum Cr, but it could not predict AKI. This study aimed to evaluate a biomarker array that may fulfill this shortage. Setting: Cardiology Department, Tanta University Hospital. Design: Prospective interventional study included 280 acute STEMI patients who underwent emergency PCI. Serial samples of blood and urine were obtained at the time of admission to the hospital (T0) and PCI unit (T1) and at 12 h and 72 h (T12 and T72) after coronary revascularization to estimate levels of serum Cr, creatine phosphokinase, and heart-type fatty acid-binding protein (H-FABP) and calculation of neutrophil/lymphocyte ratio (NLR) and urinary liver-type FABP (L-FABP). AKI was diagnosed according to the recommendations of the European Renal Best Practice as the times of increased serum Cr concerning baseline level. 85 patients developed AKI. Regression analyses defined a high NLR ratio in the T0 sample as the most significant predictor for early AKI diagnosed at T1 time, while high NLR and serum H-FABP levels in T1 samples as the significant predictors for AKI defined at T12 time. However, high urinary L-FABP levels in T12 samples and high NLR are significant predictors for AKI at T72 time. Combined estimations of serum H-FABP and urinary L-FABP with the calculation of NLR could predict the oncoming AKI and discriminate its pathogenesis. The study protocol was approved by the Local Ethical Committee at Tanta Faculty of Medicine by approval number: 35327/3/22. For blindness purposes, the authors will be blinded about the laboratory results till the end of 72 h after revascularization and the clinical pathologist will be blinded about the indication for the requested investigations.

show abstract

Acute kidney injury and in-hospital mortality in patients with ST-elevation myocardial infarction of different age groups

Cited by 17 publications

References 36 publications

Sex-related differences in clinical outcomes and predictive factors in the very elderly patients with ACS undergoing PCI

Sex-related differences in clinical outcomes and predictive factors in the very elderly patients with ACS undergoing PCI

Predicting AKI in patients with AMI: Development and assessment of a new predictive nomogram

Biomarker array for prediction of acute kidney injury after percutaneous coronary intervention for patients who had acute ST segment elevation myocardial infarction

Contact Info

Product

Resources

About