Renal failure in patients with ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention: Predictors, clinical and angiographic features, and outcomes

Vavalle, John P.; Diepen, Sean van; Clare, Robert; Hochman, Judith S.; Weaver, W. Douglas; Mehta, Rajendra H.; Pieper, Karen S.; Patel, Manesh R.; Patel, Uptal D.; Armstrong, Paul W.; Granger, Christopher B.; Lópes, Renato D.

doi:10.1016/j.ahj.2015.12.001

Cited by 28 publications

(21 citation statements)

References 17 publications

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“…In addition, low cardiac output, tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure may result in kidney congestion [24]. Similar to our results, other studies on STEMI patients undergoing PPCI showed that AHF was an independent predictor of AKI [2,8,11,12,21,25,26].…”

Section: Discussionsupporting

confidence: 87%

“…Acute kidney injury (AKI) is a frequent complication in patients with ST-elevation myocardial infarction (STEMI), leading to high morbidity and mortality in this subset of STEMI population [1][2][3]. The risk of AKI is particularly increased in STEMI patients who are older, have comorbidities, have pulmonary edema or cardiogenic shock on admission, were resuscitated before admission, in whom primary percutaneous coronary intervention (PPCI) was delayed, who have complex coronary artery disease (CAD) and/or who required multistage procedures during PPCI [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…In STEMI patients, systemic hypoperfusion, which occurs as a consequence of acute left ventricular (LV) systolic dysfunction and results in renal ischemia, appears to be important pathological mechanism underlying AKI [2,10,11]. Other factors that contribute to AKI in STEMI patients are contrast media volume (contrast-induced nephrotoxicity), increased sympathetic activity and neurohumoral activation (e.g., upregulation of angiotensin II, epinephrine and norepinephrine), enhanced inflammatory response, oxidative stress, hyperglycemia, bleeding, hypovolemia, and nephrotoxic drugs [1,2,8,9,12]. Risk factors for the development of AKI include, among others, older age, diabetes mellitus, prior or baseline chronic kidney disease, dehydration, and anemia [1,13].…”

Section: Introductionmentioning

confidence: 99%

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Predictors of acute kidney injury (AKI) in high-risk ST-elevation myocardial infarction (STEMI) patients: A single-center retrospective observational study

Sinkovič

Masnik

Mihevc

2019

Bosn J of Basic Med Sci

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Acute kidney injury (AKI) is a frequent complication in ST-elevation myocardial infarction (STEMI) patients. Factors other than contrast exposure have been suggested as major contributors to renal dysfunction in patients undergoing primary percutaneous coronary intervention (PPCI). Our aim was to assess the incidence and risk factors of AKI in high-risk STEMI patients, mostly treated by PPCI with implemented measures to prevent contrast-induced AKI. We retrospectively analyzed data of 245 STEMI patients (165 men, mean age 63.9 ± 11.9 years) admitted to the Department of Medical Intensive Care Unit. Demographic, clinical, and mortality data were compared between AKI and non-AKI group. AKI was defined as a 1.5-fold increase in serum creatinine from baseline level within 24–48 hours. AKI developed in 34/245 (13.9%) patients. PPCI was performed in 226/245 (92.2%) of all STEMI cases, with no difference between AKI and non-AKI group. There were significant differences between AKI and non-AKI group in diabetes mellitus (41.2% vs. 20.9%), prior MI (26.5% vs. 11.8%), prior resuscitation (38.2% vs. 12.4%), admission acute heart failure [AHF] (44.1% vs. 12.8%), in-hospital AHF (70.6% vs. 17.5%), and hospital-acquired infection [HAI] (79.4% vs. 18.0%). Significantly more AKI patients had increased admission CRP ≥25 mg/L (38.2% vs. 11.8%), peak CRP ≥50 mg/L (91.2% vs. 36%), admission troponin I ≥10 mg/L (44.1% vs. 24.6%), peak troponin I ≥50 mg/L (64.7% vs. 44.1%), peak NT-proBNP ≥400 pmol/L (82.4% vs. 27.5%), and ejection fraction <45% (76.5% vs. 33.6%). Mortality was significantly increased in AKI group, including in-hospital (52.9% vs. 7.1%), 30-day (64.7% vs. 10.7%) and 6-month mortality (70.6% vs. 13.7%). Significant independent predictors of AKI were prior resuscitation (OR 4.171, 95% CI 1.088–15.998), HAI (OR 7.974, 95% CI 1.992–31.912), and peak NT-proBNP (OR 21.261, 95% CI 2.357–191.795). To reduce the risk of AKI in STEMI patients, early diagnosis and treatment of AHF and HAIs are advisable.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predictors of acute kidney injury (AKI) in high-risk ST-elevation myocardial infarction (STEMI) patients: A single-center retrospective observational study

Sinkovič

Masnik

Mihevc

2019

Bosn J of Basic Med Sci

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“…Cardiovascular disease is one of the diseases with the highest fatality rates worldwide. In the United States, ~1/6th of the annual death toll is associated with coronary heart disease and associated diseases with myocardial injury (1). Acute myocardial infarction (AMI) results in ventricular remodeling that causes the deterioration of heart function leading to heart failure (2).…”

Section: Introductionmentioning

confidence: 99%

The expression of microRNA-23a regulates acute myocardial infarction in patients and inï¿½vitro through targeting PTEN

Ren

Sun

2018

Mol Med Report

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Cardiovascular disease is responsible for one of the highest rates of fatality worldwide. The present study investigated the presence and influence of microRNA (miRNA)-23a in the regulation of acute myocardial infarction (AMI). A total of 6 patients with AMI and 6 normal volunteers without myocardial disease were included, and blood samples were taken to analyze the expression of miRNA‑23a by reverse transcription‑quantitative polymerase chain reaction. miRNA‑23a expression in patients with AMI was downregulated compared with the normal group. In H9C2 cells treated with H2O2, upregulation of miRNA‑23a expression increased the superoxide dismutase, glutathione and catalase activity levels, and suppressed the malonaldehyde activity level, as determined by ELISA. Western blot analysis and a caspase‑3 substrate assay demonstrated that upregulation of miRNA‑23a expression suppressed the Bcl‑2‑associated X (Bax)/Bcl‑2 protein expression ratio, caspase‑3 activity level and tumor suppressor p53 (p53) protein expression in H2O2‑induced H9C2 cells. Furthermore, downregulation of phosphatase and tensin homolog (PTEN), by the PTEN inhibitor bpV(HOpic), increased miRNA‑23a expression and suppressed the Bax/Bcl‑2 protein expression ratio, caspase‑3 activity level and p53 protein expression in H2O2‑induced H9C2 cells. Therefore, the results of the present study indicate that the expression of miRNA‑23a may regulate AMI through targeting PTEN in patients and in vitro, and PTEN/miRNA‑23a may therefore be potential targets for the clinical treatment of AMI.

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“…Our regression analysis demonstrated that age over 80 years, female sex, higher CCI score and having an open as opposed to an endovascular procedure were all independent predictors of in‐hospital mortality. Age over 80 years, female sex, higher CCI score and open surgery are variables that certainly have been reported as risk factors for increased mortality for any cardiac/vascular interventions .…”

Section: Discussionmentioning

confidence: 99%

Increased mortality in octogenarians treated for lifestyle limiting claudication

Erben

Mena‐Hurtado

Miller

et al. 2018

Cathet Cardio Intervent

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Renal failure in patients with ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention: Predictors, clinical and angiographic features, and outcomes

Cited by 28 publications

References 17 publications

Predictors of acute kidney injury (AKI) in high-risk ST-elevation myocardial infarction (STEMI) patients: A single-center retrospective observational study

Predictors of acute kidney injury (AKI) in high-risk ST-elevation myocardial infarction (STEMI) patients: A single-center retrospective observational study

The expression of microRNA-23a regulates acute myocardial infarction in patients and inï¿½vitro through targeting PTEN

Increased mortality in octogenarians treated for lifestyle limiting claudication

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