scholarly journals Early Implementation of Veno-Venous Hemofiltration and Use of Rotational Atherectomy in a Patient with ST-Elevation Myocardial Infarction Complicated by Cardiogenic Shock- case report.

2020 ◽  
Author(s):  
Monika Durak ◽  
Marek Tomala ◽  
Bartłomiej Nawrotek ◽  
Andrzej Machnik ◽  
Jacek Legutko
Keyword(s):  
Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Case Report ◽  
Cardiogenic Shock ◽  
Right Ventricular ◽  
Kidney Injury ◽  
Novel Treatment ◽  
Early Implementation ◽  
Right Ventricular Myocardial Infarction ◽  
St Elevation

We report a patient with cardiogenic shock (CS) in the course of acute right ventricular myocardial infarction (MI). Our case highlights the use of continuous veno-venous hemofiltration as a novel treatment option for acute kidney injury in the setting of CS and the use of rotational_atherectomy in patients with MI.

scholarly journals Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction with Acute Kidney injury caused by Cardiogenic Shock, Is it Really Safe?; A Case Report

2021 ◽  
Vol 2 (3) ◽  
pp. 41-45
Author(s):  
Oktafin Srywati Pamuna ◽  
Mohammad Saifur Rohman ◽  
Setyasih Anjarwani ◽  
Cholid Tri Tjahjono
Keyword(s):  
Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
Cardiogenic Shock ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Shock Condition ◽  
Percutaneous Coronary ◽  
St Elevation

Background ST-elevation myocardial infarction (STEMI) is a life-threatening condition. Timely treatment with Percutaneous Coronary Intervention (PCI) is a recommended management of STEMI. However, in STEMI condition accompanied by complications such as prolonged shock condition and become Acute Kidney Injury (AKI), it is still a question of whether to be treated conservatively or invasively. If PPCI was an option, how to prevent the worsening outcome is still an issue Case Illustration A 53 years old, woman, was referred from a private hospital with STEMI inferior Killip IV onset 5 hours with typical chest pain and azotemia with creatinine serum was 3.4 mg/dl; eGFR 15 ml/m/1.73m2. In the emergency room, she got hydration, inotropic, and planned for PPCI. After the PPCI procedure, she was fallen into the altered mental status and then referred to our hospital. The GCS was E4V4M6; blood pressure was 118/62 mmHg (on dobutamine 10 mcg/kg BW/minutes and NE 0.3 mcg/kg BW/minutes), heart rate was 130 bpm, respiration rate was 20 times per minute, peripheral saturation was 98% on NRBM 10 liters per minute. The laboratorium result in our hospital showed a creatinine level was 1.6 mg/dl. We treated this patient for 9 days, with optimal medicamentosa and fluid therapy. There is an improvement in clinical presentation and physical examination on the last day of treatment, with urine output 1900 cc/24 hours, creatinin serum 0.8 mg/dl, and eGFR 84 ml/min/1.73m2. Conclusion Acute renal failure is a frequent complication in STEMI, leading to higher mortality, morbidity, and intrahospital complications. PPCI is a reperfusion strategy recommended by the guideline in the setting of myocardial infarction with cardiogenic shock. Proper management to prevent worsening of renal function in this condition is very important.

Right ventricular longitudinal strain predicts acute kidney injury and short-term prognosis in patients with right ventricular myocardial infarction

2018 ◽  
Vol 35 (1) ◽  
pp. 107-116 ◽  
Author(s):  
Juan Betuel Ivey-Miranda ◽  
Eduardo Almeida-Gutiérrez ◽  
Gabriela Borrayo-Sánchez ◽  
Javier Antezana-Castro ◽  
Alicia Contreras-Rodríguez ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Kidney Injury ◽  
Short Term ◽  
Right Ventricular Myocardial Infarction

scholarly journals Predictive value of stress hyperglycemia ratio for the occurrence of acute kidney injury in acute myocardial infarction patients with diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Side Gao ◽  
Qingbo Liu ◽  
Hui Chen ◽  
Mengyue Yu ◽  
Hongwei Li
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Cardiogenic Shock ◽  
Predictive Value ◽  
Kidney Injury ◽  
Left Ventricular Ejection ◽  
Diabetic Patients ◽  
Stress Hyperglycemia ◽  
Patients With Diabetes

Abstract Background Acute hyperglycemia has been recognized as a robust predictor for occurrence of acute kidney injury (AKI) in nondiabetic patients with acute myocardial infarction (AMI), however, its discriminatory ability for AKI is unclear in diabetic patients after an AMI. Here, we investigated whether stress hyperglycemia ratio (SHR), a novel index with the combined evaluation of acute and chronic glycemic levels, may have a better predictive value of AKI as compared with admission glycemia alone in diabetic patients following AMI. Methods SHR was calculated with admission blood glucose (ABG) divided by the glycated hemoglobin-derived estimated average glucose. A total of 1215 diabetic patients with AMI were enrolled and divided according to SHR tertiles. Baseline characteristics and outcomes were compared. The primary endpoint was AKI and secondary endpoints included all-cause death and cardiogenic shock during hospitalization. The logistic regression analysis was performed to identify potential risk factors. Accuracy was defined with area under the curve (AUC) by a receiver-operating characteristic (ROC) curve analysis. Results In AMI patients with diabetes, the incidence of AKI (4.4%, 7.8%, 13.0%; p < 0.001), all-cause death (2.7%, 3.6%, 6.4%; p = 0.027) and cardiogenic shock (4.9%, 7.6%, 11.6%; p = 0.002) all increased with the rising tertile levels of SHR. After multivariate adjustment, elevated SHR was significantly associated with an increased risk of AKI (odds ratio 3.18, 95% confidence interval: 1.99–5.09, p < 0.001) while ABG was no longer a risk factor of AKI. The SHR was also strongly related to the AKI risk in subgroups of patients. At ROC analysis, SHR accurately predicted AKI in overall (AUC 0.64) and a risk model consisted of SHR, left ventricular ejection fraction, N-terminal B-type natriuretic peptide, and estimated glomerular filtration rate (eGFR) yielded a superior predictive value (AUC 0.83) for AKI. Conclusion The novel index SHR is a better predictor of AKI and in-hospital mortality and morbidity than admission glycemia in AMI patients with diabetes.

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