Prolonged Hyperglycemia and Renal Failure after Primary Percutaneous Coronary Intervention

Elena Izkhakov, Zach Rozenbaum, Gilad Margolis, Shafik Khoury, Gad Keren, Yacov Shacham

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There are limited data regarding the effect of long-standing hyperglycemia on the occurrence of acute kidney injury (AKI) in ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). Methods: We retrospectively studied 723 STEMI patients undergoing primary PCI. Patients were stratified into two groups according to glycated hemoglobin (HbA1c) levels as a marker of prolonged hyperglycemia: those with HbA1c < 7% and those with HbA1c ≥7%. Medical records were reviewed for the occurrence of AKI. Results: HbA1c levels ≥7% were found in 225/723 (31%) of patients. The occurrence of AKI was significantly higher among patients with HbA1c levels ≥7% (32/225, 14%) compared to patients with HbA1c levels < 7% (32/498, 6%; p = 0.001). Patients with chronic kidney disease (CKD) and HbA1c ≥7% had an eight-fold increase in the incidence of AKI compared to patients with HbA1c < 7% and no CKD (32 vs. 4%). In a multivariable regression model, HbA1c ≥7% was independently associated with AKI (OR 1.92, 95% CI 1.09-3.36, p = 0.02). Conclusion: HbA1c ≥7% was associated with a higher likelihood of AKI in STEMI patients treated with primary PCI.

Original languageEnglish
Pages (from-to)92-99
Number of pages8
JournalCardioRenal Medicine
Volume9
Issue number2
DOIs
StatePublished - 1 Feb 2019

Keywords

  • Acute kidney injury
  • Acute myocardial infarction
  • Glycated hemoglobin
  • HbA1c

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