Influence of minor deterioration of renal function after PCI on outcome in patients with ST‐elevation myocardial infarction

Kanic, Vojko; Suran, David; Vollrath, Maja; Tapajner, Alojz; Kompara, Gregor

doi:10.1111/joic.12407

Cited by 9 publications

(8 citation statements)

References 23 publications

(38 reference statements)

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“…Renal dysfunction is one of the predisposing factors for AKI in MI patients and it also predicted AKI after propensity matching in our analysis [5, 22, 23]. Patients with renal dysfunction also suffered more bleeding (14.0% vs. 4.4%; p < 0.0001), as previously reported [13, 27–29].…”

Section: Discussionsupporting

confidence: 83%

“…This is particularly true for patients with a higher bleeding risk (women, older patients, underweight patients, and patients with renal dysfunction) [36]. In addition, early nephroprotective strategies to decrease contrast-induced renal injury, such as low contrast volume, crystalloid infusions, measures to ensure optimal hemodynamics, and discontinuation of nephrotoxic drugs, might provide a significant long-term benefit [27]. It is important to note that radial PCI in patients with MI should only be performed by an experienced radial operator [12, 13].…”

Section: Discussionmentioning

confidence: 99%

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Acute kidney injury in patients with myocardial infarction undergoing percutaneous coronary intervention using radial versus femoral access

et al. 2019

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BackgroundData on radial access (RA) as an independent risk factor for acute kidney injury (AKI) in myocardial infarction (MI) patients are conflicting. Our aim was to assess how RA influences the incidence of AKI in MI patients undergoing percutaneous coronary intervention (PCI).MethodsData from 3842 MI patients undergoing PCI at our institution from January 2011 to December 2016, of which 35.8% were performed radially, were retrospectively analyzed. A propensity-matched analysis was performed to adjust for differences in the baseline characteristics between the RA and femoral access (FA) groups. The effect of RA on the incidence of AKI was observed.ResultsIn the unmatched cohort, AKI occurred less often in the RA group [77 (5.6%) patients in the RA group compared to 250 (10.1%) patients in the FA group; p = 0.001]. After propensity-matched adjustment, the incidence of AKI was similar in the two groups.After adjustment for potential confounders, RA was not identified as an independent predictive factor for AKI in either the unmatched or the propensity-matched cohort. Bleeding, heart failure, age ≥ 70 years, renal dysfunction, and the contrast volume/GFR ratio predicted AKI in both cohorts. Additionally, diabetes, contrast volume, and hypertension were predictive of AKI in the unmatched cohort.ConclusionThe access site was not independently associated with the incidence of AKI in patients with MI in both a non-matched and a propensity-matched cohort. Our study result suggests that the lower incidence of AKI in patients treated with RA in an unmatched cohort might be substantially influenced by confounding factors, especially bleeding.Electronic supplementary materialThe online version of this article (10.1186/s12882-019-1210-8) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Acute kidney injury in patients with myocardial infarction undergoing percutaneous coronary intervention using radial versus femoral access

et al. 2019

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“…Moreover, in that study, during long-term follow-up, patients who developed episodes of AKI during hospitalization had significantly more episodes of major adverse cardiovascular events (MACE) (26% vs. 15%) and worsening of renal function (10 vs. 5%) [ 14 ]. Even slight deterioration of renal function, without meeting the criteria for AKI, has been shown to be associated with a worse long-term outcomes in patients hospitalized for AMI [ 23 ].…”

Section: Acute Kidney Injury In Patients With Myocardial Infarctionmentioning

confidence: 99%

What Promotes Acute Kidney Injury in Patients with Myocardial Infarction and Multivessel Coronary Artery Disease—Contrast Media, Hydration Status or Something Else?

2022

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Multivessel coronary artery disease (MVCAD) is found in approximately 50% of patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Although we have data showing the benefits of revascularization of significant non-culprit coronary lesions in patients with AMI, the optimal timing of angioplasty remains unclear. The most common reason for postponing subsequent percutaneous treatment is the fear of contrast-induced acute kidney injury (CI-AKI). Acute kidney injury (AKI) is common in patients with AMI undergoing PCI, and its etiology appears to be complex and incompletely understood. In this review, we discuss the definition, pathophysiology and risk factors of AKI in patients with AMI undergoing PCI. We present the impact of AKI on the course of hospitalization and distant prognosis of patients with AMI. Special attention was paid to the phenomenon of AKI in patients undergoing multivessel revascularization. We analyze the correlation between increased exposure to contrast medium (CM) and the risk of AKI in patients with AMI to provide information useful in the decision-making process about the optimal timing of revascularization of non-culprit lesions. In addition, we present diagnostic tools in the form of new biomarkers of AKI and discuss ways to prevent and mitigate the course of AKI.

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“…The most common clinical definitions of CI‐AKI are based on the increase in serum creatinine (sCr) levels and are summarized in the Table . In the present issue of the Journal of Interventional Cardiology , Kanic et al assessed the clinical relevance of minor deterioration of renal function (DRF) in patients with ST‐elevation myocardial infarction after percutaneous coronary intervention, that does not fulfill the reported criteria for AKI . In details, DFR was defined as a rise in the sCr level after PCI of ≥1 μmol/L and <26.5 μmol/L above the baseline during hospitalization.…”

Section: Ci‐aki Definitionmentioning

confidence: 99%

Editorial: Contrast‐induced acute kidney injury

Briguori

Labalestra

Condorelli

2017

J Interven Cardiology

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Influence of minor deterioration of renal function after PCI on outcome in patients with ST‐elevation myocardial infarction

Abstract: DRF identified patients at increased risk of higher long-term mortality but was not independently associated with mortality.

Cited by 9 publications

References 23 publications

Acute kidney injury in patients with myocardial infarction undergoing percutaneous coronary intervention using radial versus femoral access

Acute kidney injury in patients with myocardial infarction undergoing percutaneous coronary intervention using radial versus femoral access

What Promotes Acute Kidney Injury in Patients with Myocardial Infarction and Multivessel Coronary Artery Disease—Contrast Media, Hydration Status or Something Else?

Editorial: Contrast‐induced acute kidney injury

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