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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
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Contrast induced acute kidney injury in acute coronary syndrome patients: A single centre experience

Serdar Farhan1, Birgit Vogel2, Ioannis Tentzeris2

  • 1Third Department of Medicine, Cardiology, Wilhelminen Hospital, Austria farhanserdar@gmail.com.

European Heart Journal. Acute Cardiovascular Care
|February 28, 2015
PubMed

Insights

Contrast induced acute kidney injury is common in acute coronary syndrome patients undergoing PCI. Severe kidney injury after PCI predicts both in-hospital and long-term mortality, highlighting the need for careful monitoring.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) are at risk for contrast-induced acute kidney injury (CI-AKI).
  • Understanding predictors and outcomes of CI-AKI is crucial for patient management.

Purpose of the Study:

  • To identify predictors of CI-AKI in ACS patients treated with PCI.
  • To evaluate the impact of CI-AKI on in-hospital and long-term mortality.

Main Methods:

  • A cohort of 536 ACS patients undergoing PCI was analyzed.
  • CI-AKI was classified using Risk, Injury, Failure, Loss of kidney function, End-stage kidney disease (RIFLE)/Acute Kidney Injury Network (AKIN) criteria.
  • In-hospital and long-term mortality (94 months) were assessed, adjusting for Global Registry of Acute Coronary Events (GRACE) score parameters.

Main Results:

  • Patients with CI-AKI had worse baseline characteristics and more comorbidities.
  • Independent predictors of CI-AKI included intra-aortic balloon pump use, congestive heart failure, age >75, and admission serum creatinine >1.5 mg/dL.
  • CI-AKI RIFLE stage ≥ II independently predicted in-hospital mortality (OR 33.16) and long-term mortality (HR 4.713), even after confounder adjustment.

Conclusions:

  • CI-AKI is a frequent complication in ACS patients undergoing PCI.
  • Significant renal function deterioration post-PCI is a strong independent predictor of both short-term and long-term mortality.
Abstract

Keywords:
Acute coronary syndromeGlobal Risk of Acute Coronary Events scorecardiogenic shockcontrast induced acute kidney injurypercutaneous coronary intervention

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