Heart failure is the strongest predictor of acute kidney injury in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction

Abstract

BACKGROUND: ST elevation myocardial infarction (STEMI) patients treated by primary PCI are at high risk of acute kidney injury (AKI). AIM: To evaluate incidence, risk factors and consequences of AKI in patients undergoing primary PCI. METHODS: Retrospective analysis. RESULTS: 202 patients included. AKI occurred in 25 (12.4%) of them. Characteristics of the patients with and without AKI did not differ significantly except for age (69 ± 13 vs. 62 ± 12;p=0.003), female gender (48.0% vs. 26.6%; p=0.035), hypertension (88.0% vs.62.7%; p=0.013), LV ejection fraction (40% ± 12% vs. 49% ± 14%; p=0.002),cardiogenic shock (44.0% vs. 5.1 %; p<0.0001) and in-hospital mortality (24.0% vs. 3.4%; p=0.001). In multivariate analysis heart failure remained the only independent correlate of AKI. CONCLUSIONS: Heart failure was the strongest predictor of AKI. Other risks factors including contrast medium volume, baseline renal function, diabetes and age failed to predict AKI.