Prognostic impact and predictors of persistent renal dysfunction in acute kidney injury after percutaneous coronary intervention for acute myocardial infarction

被引:3
作者
Nakamura, Takuya [1 ]
Watanabe, Makoto [1 ]
Sugiura, Junichi [1 ]
Kyodo, Atsushi [1 ]
Nobuta, Saki [1 ]
Nogi, Kazutaka [1 ]
Nakada, Yasuki [1 ]
Ishihara, Satomi [1 ]
Hashimoto, Yukihiro [1 ]
Nakagawa, Hitoshi [1 ]
Ueda, Tomoya [1 ]
Seno, Ayako [1 ]
Nishida, Taku [1 ]
Onoue, Kenji [1 ]
Hikoso, Shungo [1 ]
机构
[1] Nara Med Univ, Dept Cardiovasc Med, 840 Shijo Cho, Kashihara, Nara 6348522, Japan
关键词
CONTRAST-INDUCED NEPHROPATHY; LONG-TERM MORTALITY; TRANSIENT; OUTCOMES;
D O I
10.1038/s41598-024-56929-y
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
This study aimed to evaluate the prognostic impact and predictors of persistent renal dysfunction in acute kidney injury (AKI) after an emergency percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). A total of 877 patients who underwent emergency PCI for AMI were examined. AKI was defined as serum creatinine (SCr) >= 0.3 mg/dL or >= 50% from baseline within 48 h after PCI. Persistent AKI was defined as residual impairment of SCr >= 0.3 mg/dL or >= 50% from baseline 1 month after the procedure. The primary outcome was the composite endpoints of death, myocardial infarction, hospitalization for heart failure, stroke, and dialysis. AKI and persistent AKI were observed in 82 (9.4%) and 25 (2.9%) patients, respectively. Multivariate Cox proportional hazards analysis demonstrated that persistent AKI, but not transient AKI, was an independent predictor of primary outcome (hazard ratio, 4.99; 95% confidence interval, 2.30-10.8; P < 0.001). Age > 75 years, left ventricular ejection fraction < 40%, a high maximum creatinine phosphokinase MB level, and bleeding after PCI were independently associated with persistent AKI. Persistent AKI was independently associated with worse clinical outcomes in patients who underwent emergency PCI for AMI. Advanced age, poor cardiac function, large myocardial necrosis, and bleeding were predictors of persistent AKI.
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页数:9
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