The Definition of 'Acute Kidney Injury' Following Percutaneous Coronary Intervention and Cardiovascular Outcomes
| Autor: | Keren Skalsky, Tamir Bental, Tali Steinmetz, Leor Perl, Amos Levi, Abid Assali, Hana Vaknin-Assa, Ran Kornowski |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Contrast Media Revascularization chemistry.chemical_compound Percutaneous Coronary Intervention Risk Factors Cause of Death Internal medicine medicine Humans Prospective Studies Registries cardiovascular diseases Myocardial infarction Israel Aged Creatinine business.industry Acute kidney injury Percutaneous coronary intervention Acute Kidney Injury Prognosis medicine.disease Survival Rate chemistry Conventional PCI Cardiology ST Elevation Myocardial Infarction Female Cardiology and Cardiovascular Medicine Complication business Biomarkers Mace Follow-Up Studies |
| Zdroj: | The American Journal of Cardiology. 156:39-43 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2021.06.033 |
| Popis: | Acute kidney injury (AKI) is a complication of percutaneous coronary intervention (PCI), known to increase rates of adverse medical events. We aimed to identify the optimal definition of AKI in predicting adverse cardiovascular outcomes and mortality post PCI. From a large registry of patients undergoing PCI between 2006-2018 (n = 25,690) at our medical center, consecutive patients were assessed for the presence of AKI according to four different definitions: a relative elevation of ≥25% or ≥50%; or an absolute elevation of ≥0.3 mg/dL or ≥0.5 mg/dL in serum creatinine at 48 hours post PCI. We assessed the calculated rates of AKI according to the different definitions. The discriminant capacity for 30-day and 1-year mortality and MACE (MACE: all-cause death, myocardial infarction, target-vessel revascularization and coronary artery bypass graft surgery) of each definition was calculated using ROC curves and AUCs. Data of 15,153 patients was available for the final analysis. Rates of AKI were 12.1%, 3.2%, 8.1% and 3.9% according to the four definitions, respectively. The discriminant capacity of adverse outcomes was highest among those defined as AKI according to the third definition - an absolute elevation of ≥0.3 mg/dL in serum creatinine with an AUC of 0.82 (95% CI 0.80-0.84) for 30-day mortality (P value = 0.036) and an AUC of 0.78 (CI 0.76-0.79) for 30-day MACE. In conclusion, an absolute elevation of ≥ 0.3 mg/dL in serum creatinine 48 hours post PCI predicts overall mortality and MACE most accurately. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect