Age-Dependent Risk of Long-Term All-Cause Mortality in Patients Post-Myocardial Infarction and Acute Kidney Injury

Area of Science:

• Cardiology
• Nephrology
• Geriatrics

Background:

• Acute myocardial infarction (AMI) is a leading cause of mortality.
• Acute kidney injury (AKI) is a known complication of AMI, impacting patient outcomes.
• Age is a significant factor influencing cardiovascular and renal health.

Purpose of the Study:

• To investigate the association between AKI and long-term all-cause mortality after AMI.
• To compare this association in elderly versus younger patient populations.
• To determine if age modifies the impact of AKI on mortality post-AMI.

Main Methods:

• Retrospective analysis of the Soroka AMI registry (2002-2017).
• Inclusion of patients with AMI and baseline eGFR > 60 mL/min/1.73 m².
• Stratification by age (elderly ≥65 years vs. younger) and AKI presence; survival analysis (Kaplan-Meier, Cox regression) for up to 10-year mortality.

Main Results:

• 10,511 patients included; AKI occurred in 15.2% (higher incidence in elderly: 20.9% vs. 11.2%).
• AKI significantly increased long-term mortality risk in both age groups.
• The association between AKI and mortality was stronger in younger patients (AdjHR 1.634) than in elderly patients (AdjHR 1.278).

Conclusions:

• AKI following AMI is linked to substantial long-term all-cause mortality risk.
• This association is present in both elderly and younger patients.
• Younger patients exhibit a stronger increased mortality risk from AKI post-AMI compared to the elderly.