Early development of acute kidney injury is an independent predictor of in-hospital mortality in patients with acute myocardial infarction
| Autor: | Toshiyuki Nagai, Satoshi Honda, Yoichi Goto, Toshihisa Anzai, Noriaki Moriyama, Teruo Noguchi, Kengo Kusano, Satoshi Yasuda, Michio Nakanishi, Yasuhide Asaumi, Shigeru Saito, Tomoaki Kanaya, Hisao Ogawa, Masashi Fujino, Masaharu Ishihara, Tetsuo Arakawa, Reiko Fujiwara, Leon Kumasaka |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Myocardial Infarction Renal function 030204 cardiovascular system & hematology urologic and male genital diseases Independent predictor 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Japan Internal medicine medicine Risk of mortality Humans In patient Hospital Mortality Registries 030212 general & internal medicine Myocardial infarction Aged Retrospective Studies Creatinine In hospital mortality urogenital system business.industry Acute kidney injury Acute Kidney Injury Prognosis medicine.disease female genital diseases and pregnancy complications Hospitalization chemistry Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiology. 69:79-83 |
| ISSN: | 0914-5087 |
| DOI: | 10.1016/j.jjcc.2016.01.001 |
| Popis: | Acute kidney injury (AKI) often occurs in patients with acute myocardial infarction (AMI), and is associated with adverse outcomes. However, it remains unclear how timing of AKI affects it. This study assessed impact of timing of AKI on prognosis after AMI.This study consisted of 760 patients with AMI who were admitted within 48h after symptom onset. AKI was diagnosed as increase in creatinine ≥0.3mg/dl or ≥50% within any 48h after admission. Patients were classified into 3 groups according to the occurrence and timing of AKI: no-AKI, early-AKI (within 48h after admission) and late-AKI (48h). Early-AKI was classified into transient early-AKI, defined as creatinine returning to the level below the criteria of AKI, and persistent early-AKI.Early-AKI occurred in 64 patients (9%) and late-AKI in 32 patients (4%). Patients with early-AKI had significantly higher mortality (35%) than those with late-AKI (7%, p0.001) and no-AKI (3%, p0.001). Multivariate analysis showed early-AKI was an independent predictor of in-hospital mortality (OR: 3.38, 95% CI: 1.30-8.76, p=0.013), but late-AKI was not. Among patients with early-AKI, mortality was significantly higher even if AKI was transient (23%, p0.001). Patients with persistent early-AKI had the highest mortality (66%, p0.001).Early-AKI was associated with worse outcome. Even if renal function once returned to baseline level, patients with early-AKI tended to be at high risk of mortality. |
| Databáze: | OpenAIRE |
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