Clinical characteristics and in-hospital outcome in percutaneous coronary interventions with ST elevation myocardial infarction patients developing acute kidney injury

Objective: To find predictors, incidence and hospital mortality of acute kidney injury in ST elevation myocardial infarction patients undergoing percutaneous coronary interventions. Methods: The retrospective cross-sectional study was conducted at Tabba Heart Institute Karachi, and comprised data from June 2013 to December 2017 of ST elevation myocardial infarction patients undergoing percutaneous coronary interventions during index admission. Acute kidney injury was defined as serum creatinine >= 0.3 mg/dl 48hrs after percutaneous coronary intervention, and was further graded into stages I-III and the need for haemodialysis. Predicted acute kidney injury risks were calculated using Mehran and National Cardiovascular Data Registry risk scores. Stata 14 was used for statistical analysis. Results: Of the 2766 cases evaluated, the incidence of acute kidney injury was found in 543(19.6%) case. Diabetes, pre-percutaneous coronary intervention heart failure, ejection fraction <40%, post-percutaneous coronary intervention thrombolysis in myocardial infarction flow<3, glomerular filtration rate<60 ml/min and increased contrast volume were significant predictors of acute kidney injury. Hospital mortality was reported in 144(5.2%) cases. Conclusion: Acute kidney injury is a serious complication in ST elevation myocardial infarction patients undergoing percutaneous coronary interventions and is related to adverse hospital outcomes. Pre-procedural risk scores may underestimate acute kidney injury in such patients.