Acute kidney injury and in-hospital mortality in patients with ST-elevation myocardial infarction of different age groups

Background: Acute kidney injury (AKI) is a risk factor for long-term adverse outcomes, including acute myocardial infarction and death. The objective of this study was to find out in-hospital outcomes in patients with acute ST elevation myocardial infarction with acute kidney injury.Methods: A total 190 patients were included in this study and were equally divided into two groups, Group-I (with AKI) and Group-II (without AKI), according to absolute changes of serum creatinine level. AKI was defined as absolute changes in serum creatinine (SCr. at 48 hours’ minus admission SCr) and categorized as mild AKI (increase of 0.3 to <0.5 mg/d), moderate AKI (increase of 0.5 to <1.0 mg/dl), and severe AKI (increase of e”1.0 mg/dl) using Acute Kidney Injury Network (AKIN) criteria.Results: Overall in-hospital mortality rate was 14.7% in Group-I (mortality rate for those with mild, moderate, and severe AKI were 7%, 13.3%, and 31.8%) compared with 5.3% in Group-II. Regarding inhospital morbidities, significant arrhythmia (29.5%) was the most common complication followed by acute heart failure (18.9%), cardiogenic shock (12.6%), and mechanical complications (4.2%) which were more in Group-I compared to patients with Group-II. After adjustment of other risk variables, the multivariate logistic regression analysis revealed AKI remained an independent predictor of in-hospital mortality with adjusted odds ratios (OR) was 4.991 (95% confidence interval, 1.873-13.301).Conclusions: AKI is an independent predictor of in-hospital mortality and morbidity. It emphasizes the importance of efforts to identify risk factors and to prevent AKI during in-hospital management of acute STEMI patients.Cardiovasc. j. 2018; 11(1): 59-66

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Routine iso-osmolar contrast media use and acute kidney injury following percutaneous coronary intervention for ST elevation myocardial infarction

Minerva Cardioangiologica ◽

10.23736/s0026-4725.19.04925-9 ◽

2019 ◽

Vol 67 (5) ◽

Cited By ~ 2

Author(s):

Diluka Premawardhana ◽

Baskar Sekar ◽

Muhammed Z. Ul-Haq ◽

Azeem Sheikh ◽

Sean Gallagher ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Kidney Injury ◽

Percutaneous Coronary Intervention ◽

Contrast Media ◽

Media Use ◽

Kidney Injury ◽

Coronary Intervention ◽

St Elevation Myocardial Infarction ◽

Percutaneous Coronary ◽

St Elevation

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Abstract 17260: In Hospital Outcomes and Prevalence of Comorbidities in Patients With ST Elevation Myocardial Infarction With and Without Infective Endocarditis - Insight From National Inpatient Sample (2013-2014)

Circulation ◽

10.1161/circ.142.suppl_3.17260 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Shakeel Jamal ◽

farah Wani ◽

Amina Khan ◽

Asim Kichloo ◽

Beth Bailey ◽

...

Keyword(s):

Myocardial Infarction ◽

Respiratory Failure ◽

Infective Endocarditis ◽

Hospital Mortality ◽

Acute Respiratory Failure ◽

Valve Replacement ◽

Kidney Injury ◽

St Elevation Myocardial Infarction ◽

National Inpatient Sample ◽

St Elevation

Introduction: In infective endocarditis (IE), embolization to the coronary arteries is an uncommon phenomenon but can contribute to transmural infarction presenting as ST elevation myocardial infarction (STEMI). Due to limited date, we intend to evaluate the clinical outcomes in hospitalized patients with STEMI with and without underlying IE. Hypothesis: Morbidity and morbidity exponentiates in STEMI with comorbid IE when compared to without IE. Methods: Patients with primary diagnosis of STEMI with and without IE were identified by querying the Healthcare Cost and Utilization (HCUP) database, specifically, National Inpatient Sample for year 2013 and 2014 based on ICD9 codes Results: During 2013 and 2014, a total of 117, 386 patients were admitted with the principle diagnosis of STEMI, out of whom 305 had comorbid IE. There was an increased in-hospital mortality (27.5% vs 10.8%, increased length of stay (14 vs 5 days), acute kidney injury (44.9% vs 18.7%), stroke (23.6% vs 3%), aortic valve replacement (9.5% vs 0.3%), mitral valve replacement (0.2%-5.2%), sepsis (50% vs 6%) and acute respiratory failure (36.7% vs 16.7%) in patients with STEMI with IE when compared to patients with STEMI and without comorbid IE. STEMI without IE had higher number of angiographies (58.7% vs 25.9%) and percutaneous coronary interventions (50.7% vs 14.4%) during their hospital course when compared to STEMI with IE. Conclusions: We conclude that hospitalized STEMI patients with concomitant diagnosis of IE are at higher risk of in-hospital mortality, increased LOS, AKI, stroke, valve replacements, and acute respiratory failure. Clinical trials that compare optimal interventions in these patients would be needed in future.

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