High Kidney Function in Myocardial Infarction Patients Who Underwent Coronary Intervention: Acute Kidney Injury Risk...

Area of Science:

• Cardiology
• Nephrology
• Clinical Research

Background:

• Acute kidney injury (AKI) is a significant complication for ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI).
• The role of high preoperative estimated glomerular filtration rate (eGFR) in predicting AKI and long-term outcomes in these patients is not well understood.

Purpose of the Study:

• To investigate the association between preoperative eGFR levels and the risk of AKI in STEMI patients undergoing PCI.
• To evaluate the impact of preoperative eGFR and AKI on 2-year adverse outcomes, including major adverse cardiovascular events (MACE) and all-cause mortality.

Main Methods:

• A multicenter, prospective cohort study included 4536 STEMI patients undergoing emergency PCI.
• Logistic regression was used to assess the association between preoperative eGFR and AKI.
• Cox regression evaluated the impact of preoperative eGFR and AKI on 2-year adverse outcomes.

Main Results:

• A U-shaped relationship was observed between preoperative eGFR and AKI risk, with both low (<60) and high (≥105 mL/min/1.73 m²) eGFR levels independently associated with increased AKI risk.
• Two-year MACE incidence increased progressively with declining eGFR.
• Patients with AKI, even with normal-to-high preoperative eGFR, faced significantly higher risks of MACE and all-cause mortality.

Conclusions:

• High preoperative eGFR is an underrecognized risk factor for AKI and adverse long-term outcomes in STEMI patients undergoing PCI.
• The findings emphasize the need for increased clinical vigilance and personalized management strategies for PCI patients with high preoperative eGFR.
• A U-shaped association between preoperative eGFR and AKI risk necessitates careful risk stratification across the entire eGFR spectrum.