Acute Kidney Injury Recovery Patterns in ST-Segment Elevation Myocardial Infarction Patients

Tamar Itach, Ariel Banai, Yael Paran, David Zahler, Ilan Merdler, David Eliashiv, Shmuel Banai, Yacov Shacham

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Acute kidney injury (AKI) is a frequent complication in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Identification of different AKI recovery patterns may improve patient prognostic stratification. We investigated the clinical relevance of AKI recovery patterns among STEMI patients undergoing PCI. Methods: A retrospective study of 2943 STEMI patients undergoing PCI. The incidence of renal impairment, in-hospital complications, short and long-term mortality, were compared between patients without AKI, with early recovery defined as a return to baseline creatinine within 72 h, and no AKI recovery/delayed recovery defined as all other AKI cases. Results: A total of 255 (8.7%) patients developed AKI, of whom 124/255 (49%) patients had an early recovery, whereas 131/255 (51%) had no AKI recovery/delayed recovery. Patients without recovery were more likely to have in-hospital complications and higher long-term mortality (36.64% vs. 7.25%%; p < 0.001). In a multivariable regression model, the mortality hazard ratio (HR) for long term mortality remained significant for patients with no/delayed recovery AKI (HR 7.76, 95% CI 4.69 to 12.86, p < 0.001), and a strong trend among patients with resolving AKI (HR 2.09, 95% CI 0.933–4.687, p = 0.071). Conclusions: Among STEMI patients undergoing PCI, the recovery pattern of AKI is a valuable prognostic marker.

Original languageEnglish
Article number2169
JournalJournal of Clinical Medicine
Volume11
Issue number8
DOIs
StatePublished - 1 Apr 2022

Keywords

  • ST-segment elevation myocardial infarction
  • acute kidney injury
  • cardiac intensive care unit
  • percutaneous coronary intervention

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