Prolonged Hyperglycemia and Renal Failure after Primary Percutaneous Coronary Intervention

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 (PCl). Methods: We retrospectively studied 723 STEMI patients undergoing primary PCl. 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 PCl . (C) 2019 S Karger AG, Basel