Acute kidney injury incidence and models for mortality prediction in acute coronary syndromes

Background and aim. The presence of acute kidney injury (AKI) in subjects diagnosed with acute coronary syndromes (ACS) represents a major predictor of a negative outcome. The purpose of this study is to reveal the incidence of AKI in ACS subjects and to illustrate the prognosis of these subjects, using special models for mortality prediction, based on the creatinine values and the presence of acute heart failure (AHF). Methods. Using multiple linear regression, several models were designed to predict the mortality including: comorbidities of the subjects, initial and highest value of the serum creatinine (sCr) during hospitalization, presence of theAHF and Killip class compared with sCr values, the last model illustrating the influence of all the previous variables. Results. AKI had a significant incidence in the chronic kidney disease (CKD) group (53.11%). The mortality rate and the hospital readmission were higher in the CKD subjects (41.14%) versus the patients with normal kidney function (21.23%, p<0.01). The association of AKI and AHF, known as cardio-renal syndrome, was related to a negative outcome in the CKD group. The models for prediction of mortality emphasize that the age, dyslipidaemio, worst sCr, Killip class and AHF presence can be used to assess the mortality risk of patients with AKI and ACS. Previous pathological conditions such as diabetes, peripheral artery disease, coronary artery disease (CAD) and obesity, failed to achieve statistically significance for prediction of death. Conclusions. AKI represents a serious pathological condition with a high prevalence in subjects with CKD, the association with AHF increases the risk of hospital readmission and fatal outcome.