Incidence of Acute Kidney Injury in Patients with Acute ST Elevation Myocardial Infarction

Abdulhussein, Mohammed A., Kareem, Fareed Murad, Ali, Shawqi Watheq Mohammed, Hadi, Najah R., Singh, Ram B., Elkilany, Galal E. and Singh, Jaipaul orcid iconORCID: 0000-0002-3200-3949 (2019) Incidence of Acute Kidney Injury in Patients with Acute ST Elevation Myocardial Infarction. World Heart Journal, 11 (2). pp. 113-121. ISSN 1556-4002

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Background: Acute kidney injury (AKI) is an important and one of the most common complications after acute myocardial infarction (AMI), affecting from 10 to 55% of patients globally. However, the mechanisms causing AKI in the first few days after an AMI are multi-factorial in nature. Recent studies suggest that AKI is associated with poor outcomes and independently predicts increasing long-term mortality. However, few studies have investigated the early risk of AKI with AMI.
Patient and methods: This was a cross-sectional study involving 110 patient with acute ST elevation during AMI. Those patients who were admitted to the coronary care unit were examined to see if they developed AKI. Complete clinical studies were carried out during the patients’ hospital stay. AKI was defined as an increase in SCr by ≥0.3 mg/dl within 48 h or an increase in SCr to ≥ 1.5 times baseline within the first 7 days of hospitalization (based on the KDIGO criteria).
Results: AKI occurred in 14 of the 110 (12.7%) patients; with 8 patients (57%) of AKI in stage 1 and 4 patients (29%) in stage 2 and 2 patients (14%) in stage 3. Patients who developed AKI were significantly more likely to be older, have hypertension, previous CAD, and diabetes mellitus than the non-AKI patients (p < 0.05 for all comparisons). Patients with AKI were significantly more likely to receive diuretics than non-AKI patients (p < 0.00052). Patients with anterior STEMI significantly developed AKI more than other type of MI (p < 0.015). Mortality was found more among STEMI patients who developed AKI (p < 0.0223). AKI in STEMI patients was more prevalent in those patients with increased serum creatinine (p < 0.047) and decreased eGFR (p < 0.0001) at time of admission.
Conclusion: AKI occurred in 12.7% (14/110) of patients hospitalized for acute STEMI. This common complication was strongly associated with mortality. The presence of a low eGFR level on admission in patients with AMI-associated AKI was related to a poor short-term survival prognosis. Patients with an impaired eGFR level upon admission who developed AKI require extensive clinical monitoring.

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