The risk of CIN and NRD among patients undergoing PCI can be reliably calculated using a novel easy-to-use computational tool (https://bmc2.org/calculators/cin). This risk prediction algorithm may prove useful for both bedside clinical decision making and risk adjustment for assessment of quality.

No abstract

AF is common among patients undergoing PCI. AF is associated with older age, the presence of other comorbidities, and independently associated with in-hospital post-procedural heart failure, cardiogenic shock, and mortality.

A cute kidney injury (AKI) is a common complication of percutaneous coronary intervention (PCI) and is associated with increased morbidity, mortality, duration of hospital stay, and healthcare cost. [1][2][3] Although AKI is generally a reversible condition, patients developing this complication post PCI may experience up to 20-fold increase in their in-hospital mortality risk. 4 Interpretation of results reported by previous studies on the association between AKI and mortality post PCI is hampered by the fact that both outcomes share common risk factors, such as hemodynamic instability, heart failure, diabetes mellitus, and preexisting chronic kidney disease. It therefore remains unclear whether the occurrence of AKI is independently associated with mortality and if the mortality risk associated with AKI is clinically relevant in relation to the broader population of patients undergoing PCI. Our study seeks to address this gap in knowledge by studying the association between AKI and in-hospital mortality after adjustment for confounding by common risk factors among a large population undergoing contemporary PCI. Second, we analyzed the attributable risk fraction of AKI-related in-hospital mortality. MethodsThis study was performed using data from the Blue Cross Blue Shield of Michigan cardiovascular consortium (BMC2), a regional registry of all patients undergoing PCI at nonfederal hospitals in Michigan. A detailed outline of the BMC2 registry has previously been described.5-7 Briefly, consecutive patients undergoing PCI at the 47 participating centers were included. Data on procedural and demographic patient characteristics, medication, laboratory values, renal Background-Acute kidney injury (AKI) post percutaneous coronary intervention (PCI) is associated with increased mortality but both death and AKI share common risk factors. Moreover, the effect of a high contrast dose, a known modifiable risk factor for AKI, on mortality is unknown. The aim of our study was to analyze the association between AKI and in-hospital mortality post PCI after adjustment for confounding by common risk factors. Methods and Results-This study was performed using a regional registry of all patients undergoing PCI in Michigan.Primary end points were AKI (serum creatinine increase >0.5 mg/dL) and all-cause in-hospital mortality. Propensity matching was performed, with each AKI patient matched to 4 controls. Attributable risk fraction and the exposed index number of AKI for mortality were calculated within the propensity-matched cohort. Between 2010 and 2013, 92 317 patients underwent PCI, of whom 2141 (2.3%) developed AKI. We matched 1371/2141 patients with AKI to 5484 controls. AKI was strongly associated with mortality (odds ratio=12.52, 95% confidence interval 9.29-16.86) in the propensity-matched cohort. The attributable risk fraction for mortality of AKI was 31.4% (95% confidence interval 26.8%-37.5%), and one death could be prevented for every 9 cases of AKI successfully avoided. The independent impact of a high contrast dose a...

BackgroundPrior research has shown a transient increase in the incidence of acute myocardial infarction (AMI) after daylight savings time (DST) in the spring as well as a decrease in AMI after returning to standard time in the fall. These findings have not been verified in a broader population and if extant, may have significant public health and policy implications.MethodsWe assessed changes in admissions for AMI undergoing percutaneous coronary intervention (PCI) in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) database for the weeks following the four spring and three fall DST changes between March 2010 and September 2013. A negative binomial regression model was used to adjust for trend and seasonal variation.ResultsThere was no difference in the total weekly number of PCIs performed for AMI for either the fall or spring time changes in the time period analysed. After adjustment for trend and seasonal effects, the Monday following spring time changes was associated with a 24% increase in daily AMI counts (p=0.011), and the Tuesday following fall changes was conversely associated with a 21% reduction (p=0.044). No other weekdays in the weeks following DST changes demonstrated significant associations.ConclusionsIn the week following the seasonal time change, DST impacts the timing of presentations for AMI but does not influence the overall incidence of this disease.

No abstract

No abstract

No abstract