Acute kidney injury in patients with ST-segment elevation acute myocardial infarction: Predictors and outcomes

Abstract

The development of acute kidney injury (AKI) in patients during hospitalization worsens the prognosis. The study aimed to estimate the prognostic value of AKI in patients with ST-segment elevation myocardial infarction (MI) in prospective follow-up study. A prospective follow-up of 12 months included 268 patients with ST-segment elevation MI who underwent percutaneous coronary intervention. The incidence of AKI was assessed and its effect on the outcome of ST-segment elevation MI during the observed period was traced. AKI was diagnosed according to Kidney Disease: Improving Global Outcomes recommendations. AKI was recorded in 20.5%. The incidence of AKI increased with decrease in the level of glomerular filtration rate on admission (P = 0.047) and an increase in the stage of acute heart failure according to Killip on admission (P = 0.006). The development of AKI was associated with an increase in-hospital mortality, increasing with a worsening stage of AKI (P<0.001), the same pattern was characteristic for death from cardiovascular causes during follow-up. AKI increases the risk of death from cardiovascular causes by four times [odds ratio 95% 4.400 (1.928-10.040), P <0.001]. The multivariate analysis revealed risk factors for the development of AKI: age >75 years (P = 0.006), female (P = 0.008), Killip >I (P = 0.045). AKI is common in patients with ST-segment elevation MI and is associated with a poor prognosis. The development of AKI is associated with an increase mortality, increasing with a worsening stage of AKI.