Acute renal impairment in older adults treated with percutaneous coronary intervention for ST-segment elevation myocardial infarction

Shafik Khoury, Gilad Margolis, Zach Rozenbaum, Keren Lee Rozenfeld, Gad Keren, Yacov Shacham

Research output: Contribution to journalArticlepeer-review

Abstract

Background Elderly individuals (≥ 75 years) constitute an increasing proportion of patients presenting with myocardial infarction treated with primary percutaneous coronary intervention (PCI), but only limited data are available regarding the incidence and prognostic implications of acute kidney injury (AKI) in this group of patients. Objective To evaluate the incidence and prognostic implications of AKI in older adults (≥ 75 years) with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI. Patients and methods A retrospective cohort, observational, single-center study of consecutive 416 older patients with STEMI (≥ 75 years) treated with primary PCI between January 2008 and August 2017 was conducted. AKI was defined as an increase of at least 0.3 mg/dl in serum creatinine within 48 h following admission. Results A total of 96/416 (23%) patients developed AKI. The occurrence of AKI was associated with adverse in-hospital outcomes, higher 30 days (25 vs. 6%; P < 0.001), and long-term mortality (46 vs. 17%; hazard ratio: 3.2; 95% confidence interval: 2.1-4.7; P < 0.001). Among patients with AKI, 46/96 (48%) demonstrated recovery of renal function at hospital discharge. Lack of renal function recovery at discharge (50/96 patients; 52%) was associated with the occurrence of new or progression of baseline chronic kidney disease. Conclusion Among older patients with STEMI undergoing primary PCI, AKI is a frequent complication associated with adverse renal short-term and long-term outcomes.

Original languageEnglish
Pages (from-to)564-568
Number of pages5
JournalCoronary Artery Disease
Volume30
Issue number8
DOIs
StatePublished - 1 Dec 2019

Keywords

  • ST-elevation myocardial infarction
  • acute kidney injury
  • ejection fraction
  • older adults
  • percutaneous coronary intervention

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