经皮冠状动脉介入治疗
医学
传统PCI
急性肾损伤
心肌梗塞
危险系数
内科学
肌酐
心脏病学
回顾性队列研究
置信区间
作者
Abdellatif El-Ahmadi,Mujahed Sebastian Abassi,Hedvig Andersson,Thomas Engstrøm,Peter Clemmensen,Steffen Helqvist,Erik Jørgensen,Henning Kelbæk,Frants Pedersen,Kari Saunamäki,Jacob Lønborg,Lene Holmvang
出处
期刊:PLOS ONE
[Public Library of Science]
日期:2019-12-20
卷期号:14 (12): e0226625-e0226625
被引量:20
标识
DOI:10.1371/journal.pone.0226625
摘要
The aim of the study was to investigate the incidence, risk factors and long-term prognosis of acute kidney injury (AKI) in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (primary PCI).A large-scale, retrospective cohort study based on procedure-related variables, biochemical and mortality data collected between 2009 and 2014 at Rigshospitalet, Copenhagen, Denmark. AKI was defined as an increase in serum creatinine of 25% during the first 72 hours after the index procedure.A total of 4239 patients were treated with primary PCI of whom 4002 had available creatinine measurements allowing for assessment of AKI and inclusion in this study. The mean creatinine value upon presentation for all patients was 84 μmol/l (standard deviation (SD) ±40) and 97 μmol/l (SD ±53) at peak. AKI occurred in a total of 765 (19.1%) patients. Independent risk factors for the occurrence of AKI were age, time from symptom onset to procedure, peak value of troponin-T, female sex and the contrast volume to eGFR ratio. In a multivariable adjusted analysis AKI was independently associated with a higher mortality rate at 5 years follow-up (hazard ratio 1.39 [95%-confidence interval 1.03-1.88]).In STEMI patients treated with primary PCI one in five experiences acute kidney injury, which was associated with a substantial increase in both short- and long-term mortality.
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