Acute cardiorenal anemia syndrome among ST-elevation myocardial infarction patients treated by primary percutaneous intervention
| Autor: | Ilan Merdler, Amir Gal-Oz, David Zahler, Aviram Hochstadt, Dana Levit, Yacov Shacham, Shmuel Banai, Itamar Loewenstein |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous Anemia 030204 cardiovascular system & hematology urologic and male genital diseases Logistic regression 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine St elevation myocardial infarction Internal medicine medicine Humans 030212 general & internal medicine Myocardial infarction Israel Retrospective Studies business.industry Medical record Acute kidney injury General Medicine Acute Kidney Injury Middle Aged medicine.disease female genital diseases and pregnancy complications Heart failure ST Elevation Myocardial Infarction Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Coronary Artery Disease. 32:275-280 |
| ISSN: | 0954-6928 |
| DOI: | 10.1097/mca.0000000000000973 |
| Popis: | BACKGROUND Acute kidney injury (AKI) and anemia have been extensively studied in ST-elevation myocardial infarction (STEMI), yet the precise nature of their reciprocal relationship has not been elucidated in STEMI patients. METHODS We performed a retrospective analysis of 2096 consecutive patients admitted for STEMI between January 2008 and December 2018 and treated with primary coronary intervention. Patients were stratified into four groups according to the presence of baseline anemia and occurrence of AKI: without anemia or AKI, baseline anemia without AKI, AKI without baseline anemia and acute cardiorenal anemia syndrome (CRAS), defined as the occurrence of AKI in patients with baseline anemia. Patients' medical records were reviewed for in-hospital complications, 30-day and long-term mortality. RESULTS The mean age was 61 ± 13 years and 1682 patients (80%) were men. Ten percent of patients had baseline anemia without AKI, 7% had AKI without baseline anemia and 3% were classified as CRAS. We found increments between the four groups for occurrence of new onset atrial fibrillation and heart failure rates, presence of a critical state, and both 30-day and long-term mortality (P < 0.001 for all). Logistic regression models demonstrated that as compared to AKI alone, CRAS was associated with a higher risk for long-term mortality (HR 10.49; 95% CI 6.5-17.1) as compared to anemia (HR 3.32, 95% CI 2.1-5.2) and AKI (HR 7.71, 95% CI 5.1-11.7) alone (P < 0.001 for all). CONCLUSIONS Among STEMI patients, the interaction between anemia and AKI is associated with worse short and long-term outcomes and reflects the reciprocity of cardiac and renal exacerbations. |
| Databáze: | OpenAIRE |
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