scholarly journals Impact of Baseline Admission Serum Creatinine Level in ST Segment Elevated Myocardial Infarction (STEMI) Patient Undergoing Primary PCI: An Important Predictor of in-hospital and 12-month Survival Outcome

2020 ◽  
Vol 12 (2) ◽  
pp. 135-142
Author(s):  
AHM Waliul Islam ◽  
Shams Munwar ◽  
Shahabuddin Talukder ◽  
AQM Reza ◽  
Azfar H Bhuiyan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Creatinine Level ◽  
Stemi Patient ◽  
Important Predictor ◽  
Primary Pci ◽  
Baseline Serum ◽  
Group A ◽  
Group B

Background: Several studies has shown that impaired renal function might be an important predictor of adverse cardiovascular events in patient with ST elevated myocardial Infarction (STEMI) undergoing primary percutaneous intervention (pPCI). Exact data on clinical impact of baseline or admission serum creatinine level of STEMI patient undergoing pPCI in our patient population not well established. Therefore, we have carried out this non-randomized study to see the effects of S. creatinine level on major adverse cardiovascular outcomes among STEMI patient undergoing pPCI. Methods: Patients were enrolled in this observational non-randomized prospective cohort between November 2017-July 2019, who were presented into our emergency department with acute onset of severe chest pain or angina with ECG evidenced of acute ST elevated myocardial infarction. Total 137 patient (F 12; Male 125) were enrolled in this study. Results: Out of 137 patients, female :12 (8.75%) vs Male: 125 (91.2%). Among, these patient females were more obese (BMI: Female 27.0 ± 2.2 vs male 25.4 ± 4.9) and developed CAD in advance age (Female 59.1 ± 14.5 vs Male 53.4 ± 10.5). Among the 137 patients, 89 (65%) were dyslipidemia, 72 (52.6%) were hypertensive, Diabetic 66(48%), Smoker 70 (51%) and FH positive for CAD were 31 (22.6%). According to the involvement of myocardium infarction, STEMI diagnosis of Anterior MI were 48.9% (n=67) and Inferior MI 51.1% (n=70). An elevated serum creatinine level was defined as creatinine >1.2mg/dl. Based on baseline serum creatinine level, patients were divided into group-A and Group-B. In Group-A. Total 68 patients have S. Creatinine level <1.2 and in Group-B, 69 patients have S. Creatinine level >1.2. Anterior MI were higher in group -B patient than Group-A; Ant MI as 35 (50.4%) vs 31(45.6%), Inf MIL: 34 (49.35) vs 34 (50%), Shock 11 (15.9%) vs 6 (8.8%0, CHB 4 (5.8%) vs 4 (5.9%), Death 12 (17.4%) vs 2 (2.9%) and LVF 5(7.2%) vs 1(1.5%) with 7 days in-hospital stay after primary PCI. Territory wise involvement of vessel in Group-B patient has more involvement of LAD 35 (50.7%) and Group-A has RCA 26(38.2%). Conclusion: In this present study, we found, that in acute STEMI patients, baseline higher serum creatinine level is associated with more AMI related complications and death than in lower serum creatinine level. Thus, we may conclude that baseline admission serum creatinine level may be an important predictor for both in-hospital and 12-month survival outcomes in STEMI patients undergoing pPCI. Cardiovasc. j. 2020; 12(2): 135-142

Risk of acute kidney injury associated with neuroimaging obtained during triage and treatment of patients with acute ischemic stroke symptoms

2016 ◽  
Vol 8 (12) ◽  
pp. 1231-1234 ◽  
Author(s):  
Shelby L Hall ◽  
Stephan A Munich ◽  
Marshall C Cress ◽  
Leonardo Rangel-Castilla ◽  
Elad I Levy ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Ischemic Stroke ◽  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Acute Ischemic Stroke ◽  
Creatinine Level ◽  
Kidney Injury ◽  
Vascular Pathology ◽  
Baseline Serum ◽  
Iodinated Contrast

BackgroundCombining non-contrast CT (NCCT), CT angiography (CTA), and CT perfusion (CTP) imaging (referred to as a CT stroke study, CTSS) provides a rapid evaluation of the cerebrovascular axis during acute ischemic stroke. Iodinated contrast-enhanced CT imaging is not without risk, which includes renal injury. If a patient's CTSS identifies vascular pathology, digital subtraction angiography (DSA) is often performed within 24–48 h. Such patients may receive multiple administrations of iodinated contrast material over a short time period.ObjectiveWe aimed to evaluate the incidence of acute kidney injury (AKI) in patients who underwent a CTSS and DSA for evaluation of acute ischemic symptoms or for stroke intervention within a 48 h period between August 2012 and December 2014.MethodsWe identified 84 patients for inclusion in the analysis. Patients fell into one of two cohorts: AKI, defined as a rise in the serum creatinine level of ≥0.5 mg/dL from baseline, or non-AKI. Clinical parameters included pre- and post-imaging serum creatinine level, time between CTSS and DSA, and type of angiographic procedure (diagnostic vs intervention) performed.ResultsFour patients (4.7%) experienced AKI, one of whom had baseline renal dysfunction (defined as baseline serum creatinine level ≥1.5 mg/dL). The mean difference between baseline and peak creatinine values was found to be significantly greater in patients with AKI than in non-AKI patients (1.65 vs −0.09, respectively; p=0.0008).ConclusionsThis study provides preliminary evidence of the safety and feasibility of obtaining CTSS with additional DSA imaging, whether for diagnosis or intervention, to identify possible acute ischemic stroke.

Comparison of Allopurinol And Febuxostat in Asymptomatic Hyperuricemic Patients and their Impact on Serum Creatinine

2019 ◽  
Vol 10 (1) ◽  
pp. 17-21
Author(s):  
Tafazzul Hussain ◽  
Musarrat Sultana ◽  
Syeda Amber Zaidi ◽  
Syed Saud Hasan ◽  
Mohsin Turab ◽  
...  
Keyword(s):  
Renal Function ◽  
Uric Acid ◽  
Serum Creatinine ◽  
Serum Uric Acid ◽  
Blood Parameters ◽  
Mean Difference ◽  
P Value ◽  
Baseline Serum ◽  
Group A ◽  
Group B

Objective: To determine the effect of Allopurinol & Febuxostat for the treatment of hyperuricemic patients & its influence on renal function by measuring serum creatinine level. Study Design & setting: The clinical trial was conducted at Dr. Ruth K M Pfau Civil Hospital, Karachi, during the period of September 2018 to March 2019 Methodology: 60 patients with sUA > 6.8 mg/dl were registered. A detailed history was taken, patient's baseline serum Uric Acid (sUA) & serum Creatinine were measured. Patients were divided into two groups to receive Allopurinol, 300 mg & Febuxostat 80 mg, daily for 90-days. The blood parameters were repeated at day 30 and 90. Results: Group-A (Allopurinol treated patients) baseline uric acid changed from mean 8.79 ± 0.98 mg/dl to 6.40 ± 0.86 mg/dl at day 90. In Group-B (Febuxostat treated patients) sUA baseline mean changed from 8.85 ± 0.97 mg/dl to 5.96 ± 0.68 mg/dl. Mean difference ± SD change of serum uric acid in Group-A was 2.39 ± 1.15 mg/dl and with Group-B it was 2.90 ± 0.87 mg/dl. Mean Serum Creatinine in Group-A changed from 1.54 ± 0.39 mg/dl to mean 1.48 ± 0.40 mg/dl compared with Group-B where it changed from 1.42 ± 0.30 mg/dl to 1.45 ± 0.31 mg/dl at day-90. Mean difference ± SD of serum Creatinine in Group-A was 0.11 ± 0.25 mg/dl & in Group-B it was, 0.03 ± 0.15 mg/dl. The above changes were statistically non-significant with p-value of 0.144. Conclusion: Allopurinol and Febuxostat treatment resulted in improvement of serum Uric Acid levels while maintaining their renal function

scholarly journals Efficacy of Low-Dose Dopamine in Preventing Amphotericin B Nephrotoxicity in Bone Marrow Transplant Patients and Leukemia Patients

1998 ◽  
Vol 42 (12) ◽  
pp. 3103-3106 ◽  
Author(s):  
Mary J. Camp ◽  
John R. Wingard ◽  
Claire E. Gilmore ◽  
Lillian S. Lin ◽  
Suzanne P. Dix ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Amphotericin B ◽  
Bone Marrow Transplant ◽  
Creatinine Level ◽  
Low Dose ◽  
Marrow Transplant ◽  
Drug Reactions ◽  
Baseline Serum

ABSTRACT This study evaluated the efficacy of low-dose dopamine for prevention of amphotericin B-induced nephrotoxicity in autologous bone marrow transplant and leukemia patients. Seventy-one patients undergoing cytoreductive therapy who required amphotericin B were randomly assigned in an unblinded fashion to a group receiving continuous-infusion low-dose dopamine (3 μg/kg/min) or a group receiving no dopamine. Amphotericin B was dosed at 0.5 or 1.0 mg/kg/day based on computerized tomography scan results or presence of positive blood cultures. No patient received saline boluses. The rate of nephrotoxicity, severity as graded by Southwest Oncology Group toxicity criteria, and time to each grade of nephrotoxicity were compared between the two groups. Eighty percent of the no-dopamine group and 66.7% of the dopamine group developed nephrotoxicity, defined as a 1.5-fold or greater increase in baseline serum creatinine level (P = 0.20). No statistical difference was noted at any grade of nephrotoxicity between the two groups. Thirty-four percent of patients in the no-dopamine group versus 17.6% in the dopamine group had a 2.5-fold or greater increase in serum creatinine level, which was not statistically significant (P = 0.0888). Ten patients developed grade IV nephrotoxicity and were withdrawn from the study, 7 in the no-dopamine group and 3 in the dopamine group (P = 0.19). The time to each grade of nephrotoxicity was also not significantly different for the two groups. Eleven adverse drug reactions were reported in the dopamine group in comparison to one in the no-dopamine group. Thus, dopamine offers little in the way of prevention of nephrotoxicity associated with amphotericin B therapy. Although the significance of drug reactions in the dopamine group is not clearly established due to lack of cardiac monitoring in the no-dopamine group, dopamine therapy is not without complications.

Abstract 19724: Renoprotective Effect of Remote Ischemic Peri-conditioning During Air Medical Transport of Patients With ST-segment Elevation Myocardial Infarction

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Oladipupo Olafiranye ◽  
Adetola Ladejobi ◽  
Christian Martin-Gill ◽  
Catalin Toma
Keyword(s):  
Myocardial Infarction ◽  
Serum Creatinine ◽  
Clinical Characteristics ◽  
Left Ventricular ◽  
Primary Pci ◽  
Baseline Serum ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Increased Risk

Background: Acute kidney injury (AKI) manifesting as acute increase in serum creatinine is a recognized complication to cardiac catheterization. Patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI) have a markedly increased risk of developing AKI. At present, there is no universally accepted strategy for prevention of AKI in the setting of primary PCI. We assessed whether remote ischemic peri-conditioning (RIPC) stimulus during ambulance transport of STEMI patient would reduce the rate of creatinine rise post primary PCI. Method: We evaluated STEMI patients transferred to two hospitals participating in the National Cardiovascular Data Registry (NCDR) Acute Coronary Treatment Intervention Outcomes Network Registry-Get With the Guidelines (ACTION Registry-GWTG) between March, 2013 and March, 2015. Patients were transferred by an air medical critical care service utilizing RIPC as part of a standard protocol and compared to controls matched by referring location/facility. Patient demographics, clinical characteristics, treatments, cardiac biomarkers, left ventricular function, serum creatinine and rate of any increase in creatinine post PCI were compared by the presence or absence of RIPC during transport. Results: Out of the 221 STEMI patients (Age, 63±12.7 yrs; 32.6% female) in this analysis, 107 received RIPC and 114 did not. Baseline characteristics were similar between the two groups. RIPC group had significantly lower rate of creatinine rise post PCI (38.6% vs 55.2%; OR, 1.40; CI, 1.03-1.90; p=0.03) despite having similar baseline serum creatinine (median (IQR), 1.0(0.36) mg/dl vs. median (IQR), 1.0(0.4) mg/dl; p=0.46). In multivariable logistic regression analysis adjusting for demographic factors and clinical characteristics, RIPC (OR, 1.62; CI, 1.12-2.35; p=0.01) was independently associated with lower rate of creatinine rise post PCI. Conclusion: Among patients with STEMI undergoing primary PCI, RIPC before hospital arrival compared with no RIPC was associated with significantly lower rate of creatinine rise post PCI. The use of RIPC as a potential renoprotective strategy for STEMI patients warrants further investigation.

scholarly journals Kidney histotexure and serum creatinine level in response to concurrent administration of alcohol and coffee in mice

2016 ◽  
Vol 32 (2) ◽  
pp. 42-47
Author(s):  
MT Islam ◽  
MK Islam ◽  
MZ Hossain ◽  
MA Wares
Keyword(s):  
Drinking Water ◽  
Renal Function ◽  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Creatinine Level ◽  
Control Group ◽  
Pathological Changes ◽  
Concurrent Administration ◽  
Group A ◽  
High Doses

The effect of alcohol and coffee on renal function with pathological changes in kidney was determined in mice. Sixty Albino mice were randomly divided into six equal groups. The mice of group A were maintained as control and remaining five groups were used as treated groups. The mice of control group were supplied with normal mice pellets whereas other groups were supplied with same pellets in addition to 5% coffee (in drinking water), 10% coffee, 10% alcohol, 5% coffee plus 5% alcohol and 10% coffee plus 10% alcohol, for 90 days. The serum creatinine level was significantly (P<0.01) higher in groups supplied with alcohol. There was huge infiltration of reactive cells and mild haemorrhagic spots in kidney of mice that received 10% coffee and 10% alcohol, respectively. It is suggested that long use of high doses of alcohol and coffee impaired kidney function.Bangl. vet. 2015. Vol. 32, No. 2, 42-47

MO1002EFFICACY OF PLASMAPHERESIS IN KIDNEY TRANSPLANT PATIENTS WITH FOCAL SEGMENTAL GLOMERULOSCLEROSIS : A SINGLE CENTER EXPERIENCE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Imen El Meknassi ◽  
Zellema Dorsaf ◽  
Azzabi Awatef ◽  
Sahtout Wissal ◽  
Ben Aicha Narjes ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Kidney Transplant ◽  
Creatinine Level ◽  
Focal Segmental Glomerulosclerosis ◽  
Renal Diseases ◽  
Baseline Serum ◽  
Segmental Glomerulosclerosis ◽  
The Mean

Abstract Background and Aims Plasmapheresis (PP) have been used in kidney transplant (KT) patients for multiple immunological renal diseases. Focal segmental glomerulosclerosis (FSGS) is one of the most prevalent indication for PP. It can be used either for curative or preventive treatment of its recurrence. The aim of our study was to assess the outcomes of PP among KT patients with FSGS. Method We performed a retrospective study including all KT patients with FSGS who underwent PP during the period from December 2007 to December 2018. PP was performed using a filtration technique by a Prismaflex machine. Results Among 275 KT patients, we have identified 5 patients with FSGS who underwent PP either before or after transplantation. The mean age was 26.4 years. All patients but one received a living-donor kidney with number of mismatches between 3 and 5. All patients were under corticosteroids, mycophenolate mofetil and cyclosporine. Two patients presented recurrent FSGS within 3 days following the transplantation. Mean serum creatinine level and proteinuria before PP were 517 ±191 µmol/l and 17.7 ±7.5 g/day respectively. The PP was used basing on Canaud protocol combined to rituximab. The mean number of PP sessions was 29. Only one patient required hemodialysis. None of the patients had lost his graft. The mean serum creatinine level was 172±55 µmol/l. One patient died of septic shock. PP was used in two other patients before transplantation in order to prevent the recurrence of FSGS. They have preserved a normal kidney function after a period of follow-up (37 months and 7 years). No rejection or recurrence of FSGS was noted during the follow-up period. Another patient aged 20, underwent 5 sessions of PP on alternate days immediately after transplantation to prevent the recurrence of FSGS. His baseline serum creatinine level was at 136 µmol/l. The recurrence of his initial renal disease occurred after 21 months requiring other sessions of PP. Rituximab was tried but stopped in front of allergy reaction. His renal function remained stable. Overall, PP was well tolerated in all patients with no incident. Conclusion Recurrence of the FSGS after transplantation is a concern for nephrologists due to the difficulty of treatment. Our study shows the efficacy of plasmapheresis before kidney transplantation to prevent recurrence of FSGS.

scholarly journals Effects of stent generation on clinical outcomes after acute myocardial infarction compared between prediabetes and diabetes patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong Hoon Kim ◽  
Ae-Young Her ◽  
Myung Ho Jeong ◽  
Byeong-Keuk Kim ◽  
Sung-Jin Hong ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Clinical Outcomes ◽  
Secondary Outcome ◽  
Drug Eluting Stent ◽  
Diabetes Group ◽  
Repeat Revascularization ◽  
Group A ◽  
Group B ◽  
Diabetes Patients

AbstractWe investigated the effects of stent generation on 2-year clinical outcomes between prediabetes and diabetes patients after acute myocardial infarction (AMI). A total of 13,895 AMI patients were classified into normoglycemia (group A: 3673), prediabetes (group B: 5205), and diabetes (group C: 5017). Thereafter, all three groups were further divided into first-generation (1G)-drug-eluting stent (DES) and second-generation (2G)-DES groups. Patient-oriented composite outcomes (POCOs) defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization were the primary outcome. Stent thrombosis (ST) was the secondary outcome. In both prediabetes and diabetes groups, the cumulative incidences of POCOs, any repeat revascularization, and ST were higher in the 1G-DES than that in the 2G-DES. In the diabetes group, all-cause death and cardiac death rates were higher in the 1G-DES than that in the 2G-DES. In both stent generations, the cumulative incidence of POCOs was similar between the prediabetes and diabetes groups. However, in the 2G-DES group, the cumulative incidences of Re-MI and all-cause death or MI were significantly higher in the diabetes group than that in the prediabetes group. To conclude, 2G-DES was more effective than 1G-DES in reducing the primary and secondary outcomes for both prediabetes and diabetes groups.

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