TY - JOUR T1 - Impact of contrast-induced acute kidney injury on outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. AU - Kume,Kiyoshi, AU - Yasuoka,Yoshinori, AU - Adachi,Hidenori, AU - Noda,Yoshiki, AU - Hattori,Susumu, AU - Araki,Ryo, AU - Kohama,Yasuaki, AU - Imanaka,Takahiro, AU - Matsutera,Ryo, AU - Kosugi,Motohiro, AU - Sasaki,Tatsuya, Y1 - 2013/08/28/ PY - 2013/05/31/received PY - 2013/07/22/revised PY - 2013/07/22/accepted PY - 2013/9/3/entrez PY - 2013/9/3/pubmed PY - 2014/4/23/medline KW - Contrast-induced acute kidney injury KW - Primary percutaneous coronary intervention KW - Renal insufficiency KW - ST-segment elevation myocardial infarction SP - 253 EP - 7 JF - Cardiovascular revascularization medicine : including molecular interventions JO - Cardiovasc Revasc Med VL - 14 IS - 5 N2 - PURPOSE: The purpose of this study was to identify predictors of contrast-induced acute kidney injury (CI-AKI) and the effect of CI-AKI on cardiovascular outcomes after hospital discharge in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). METHODS AND MATERIALS: We retrospectively reviewed 194 STEMI consecutive patients who underwent primary PCI to evaluate the predictors for CI-AKI and 187 survivors to examine all-cause mortality and cardiovascular events. Outcomes were compared between patients with CI-AKI and those without CI-AKI, which was defined as an increase >50% or >0.5mg/dl in serum creatinine concentration within 48hours after primary PCI. RESULTS: CI-AKI occurred in 23 patients (11.9%). Multivariate analysis identified pre-procedural renal insufficiency as a predictor of CI-AKI, and this predictor was independent from hemodynamic instability and excessive contrast volume. Receiver-operator characteristics analysis demonstrated that patients with an estimated glomerular filtration rate (eGFR) of ≤43.6ml/min per 1.73m(2) had the potential for CI-AKI. Patients who developed CI-AKI had higher mortality and cardiovascular events than did those without CI-AKI (27.8% vs. 4.7%; log-rank P=.0003, 27.8% vs. 11.2%; log-rank P=.0181, respectively). Cox proportional hazards model analysis identified CI-AKI as the independent predictor of mortality and cardiovascular events [hazard ratio [HR]=5.36; P=.0076, HR=3.10; P=.0250, respectively]. CONCLUSIONS: The risk of CI-AKI is increased in patients with pre-procedural renal insufficiency, and eGFR is clinically useful in the emergent setting for CI-AKI risk stratification before primary PCI. SN - 1878-0938 UR - https://www.unboundmedicine.com/medline/citation/23993293/Impact_of_contrast_induced_acute_kidney_injury_on_outcomes_in_patients_with_ST_segment_elevation_myocardial_infarction_undergoing_primary_percutaneous_coronary_intervention_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1553-8389(13)00118-8 DB - PRIME DP - Unbound Medicine ER -