Contrast-induced acute kidney injury and mortality in ST elevation myocardial infarction treated with primary percutaneous coronary intervention

医学 经皮冠状动脉介入治疗 急性肾损伤 来复枪 心肌梗塞 内科学 肾脏疾病 心脏病学 造影剂肾病 肾功能 历史 考古
作者
Johanne Silvain,Lee S. Nguyen,Vincent Spagnoli,Mathieu Kerneïs,Paul Guedeney,Nicolas Vignolles,K. Cosker,Olivier Barthélémy,Claude Le Feuvre,Gérard Helft,Jean‐Philippe Collet,Gilles Montalescot
出处
期刊:Heart [BMJ]
卷期号:104 (9): 767-772 被引量:60
标识
DOI:10.1136/heartjnl-2017-311975
摘要

Objectives Contrast-induced acute kidney injury (CI-AKI) is a common and potentially severe complication in patients with ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). There is no consensus on the best definition of CI-AKI to identify patients at risk of haemodialysis or death. The objective of this study was to assess the association of CI-AKI, using four definitions, on inhospital mortality, mortality or haemodialysis requirement over 1-year follow-up, in patients with STEMI treated with pPCI. Methods In this prospective, observational study, all patients with STEMI referred for pPCI were included. We identified independent variables associated with CI-AKI and mortality. Results We included 1114 consecutive patients with STEMI treated by pPCI. CI-AKI occurred in 18.3%, 12.2%, 15.6% and 10.5% of patients according to the CIN, Acute Kidney Injury Network (AKIN), Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease (RIFLE) Modification of Diet in Renal Disease (MDRD) and RIFLE Chronic Kidney Disease - Epidemiology Collaboration (CKD-EPI) definitions, respectively. The RIFLE (CKD-EPI) definition was the most discriminant definition to identify patients at higher risk of inhospital mortality (27.1% vs 4.0%; adjusted OR 2.7 (95% CI 1.4 to 5.1), p=0.003), 1-year mortality (27.4% vs 6.6%; adjusted OR 2.8 (95% CI 1.5 to 5.3), p=0.002) and haemodialysis requirement at 1-year follow-up (15.6% vs 2.7%; adjusted OR 6.7 (95% CI 3.3 to 13.6), p=0.001). Haemodynamic instability, cardiac arrest, preexisting renal failure, elderly age and a high contrast media volume were independently associated with 1-year mortality. Of interest, contrast-media volume was not correlated to increase of creatininaemia (r=0.06) or decrease in estimated glomerular filtration rate (r=0.05) after percutaneous coronary intervention in our population. Conclusions CI-AKI is a frequent and serious complication of STEMI treated by pPCI. The RIFLE definition is the most accurate definition to identify patients with CI-AKI at high risk of mortality or haemodialysis.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
zyyyy完成签到,获得积分10
1秒前
温润如玉坤完成签到,获得积分10
2秒前
十一完成签到,获得积分20
2秒前
cm完成签到,获得积分10
3秒前
一台小钢炮完成签到,获得积分10
4秒前
4秒前
Wguan发布了新的文献求助20
4秒前
英俊的铭应助asdf采纳,获得10
4秒前
我是老大应助123采纳,获得10
5秒前
陨落的繁星完成签到,获得积分10
5秒前
十一发布了新的文献求助10
5秒前
顺科研发布了新的文献求助10
5秒前
李多多完成签到,获得积分10
5秒前
浪浪山第一酷完成签到,获得积分10
6秒前
眼睛大的胡萝卜完成签到 ,获得积分10
6秒前
顺心的飞飞完成签到,获得积分10
6秒前
ymh完成签到,获得积分10
7秒前
dropofwater完成签到,获得积分10
7秒前
文章快快来完成签到,获得积分10
7秒前
ZX612完成签到,获得积分10
7秒前
全糖完成签到,获得积分10
7秒前
DICPGLF完成签到,获得积分10
7秒前
炎帝完成签到 ,获得积分10
8秒前
Dritsw应助熬夜的桃子采纳,获得10
9秒前
李爱国应助renwoxing采纳,获得10
9秒前
QQ完成签到,获得积分10
9秒前
10秒前
10秒前
10秒前
传奇3应助大美女采纳,获得10
10秒前
哈哈2022完成签到,获得积分10
10秒前
7890733完成签到,获得积分10
11秒前
12秒前
man完成签到 ,获得积分10
12秒前
张兰发布了新的文献求助10
12秒前
12秒前
FashionBoy应助hhh采纳,获得10
13秒前
冷酷的松思完成签到,获得积分10
13秒前
修梨完成签到,获得积分20
13秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Immigrant Incorporation in East Asian Democracies 600
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3968608
求助须知:如何正确求助?哪些是违规求助? 3513486
关于积分的说明 11168243
捐赠科研通 3248926
什么是DOI,文献DOI怎么找? 1794540
邀请新用户注册赠送积分活动 875188
科研通“疑难数据库(出版商)”最低求助积分说明 804676