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Acute kidney injury among ST elevation myocardial infarction patients treated by primary percutaneous coronary

Yacov Shacham1, Arie Steinvil2, Yaron Arbel2

  • 1Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizman Street, 64239, Tel Aviv, Israel. kobyshacham@gmail.com.

Journal of Nephrology
|February 11, 2016
PubMed

Insights

Acute kidney injury is common in ST-elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (PCI). This review explores factors beyond contrast nephropathy contributing to kidney injury in these patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Acute kidney injury (AKI) is a significant complication in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).
  • AKI is linked to poorer patient outcomes.
  • Contrast nephropathy is often cited as the primary cause of renal function decline, but other factors are increasingly recognized.

Purpose of the Study:

  • To review and analyze the multifactorial causes of renal impairment in STEMI patients undergoing primary PCI.
  • To contextualize these factors within the current treatment era.

Main Methods:

  • Literature review focusing on renal function in STEMI patients post-primary PCI.
  • Analysis of contributing factors including contrast nephropathy, reperfusion time, cardiac function, hemodynamics, and inflammatory/metabolic markers.

Main Results:

  • While contrast nephropathy plays a role, other factors significantly impact renal function.
  • Key contributors include the timeliness of coronary reperfusion, cardiac pump efficiency, hemodynamic stability, and systemic inflammatory and metabolic responses.

Conclusions:

  • Renal impairment in STEMI patients undergoing primary PCI is multifactorial.
  • A comprehensive understanding beyond contrast nephropathy is crucial for managing and preventing AKI in this population.

Keywords:
Acute kidney injuryContrast induced nephropathyPercutaneous coronary interventionST elevation myocardial infarction

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