PMID- 28617038
OWN - NLM
STAT- MEDLINE
DCOM- 20190118
LR  - 20190118
IS  - 2048-8734 (Electronic)
IS  - 2048-8726 (Linking)
VI  - 7
IP  - 8
DP  - 2018 Dec
TI  - Relation of subclinical serum creatinine elevation to adverse in-hospital 
      outcomes among myocardial infarction patients.
PG  - 732-738
LID - 10.1177/2048872617716389 [doi]
AB  - BACKGROUND: Acute kidney injury is associated with adverse outcomes after acute 
      ST elevation myocardial infarction (STEMI). It remains unclear, however, whether 
      subclinical increase in serum creatinine that does not reach the consensus 
      criteria for acute kidney injury is also related to adverse outcomes in STEMI 
      patients undergoing primary percutaneous coronary intervention. METHODS: We 
      conducted a retrospective study of 1897 consecutive STEMI patients between 
      January 2008 and May 2016 who underwent primary percutaneous coronary 
      intervention, and in whom acute kidney injury was not diagnosed throughout 
      hospitalization. We investigated the incidence of subclinical acute kidney injury 
      (defined as serum creatinine increase of >/= 0.1 and < 0.3 mg/dl) and its relation 
      to a composite end point of adverse in hospital outcomes. RESULTS: Subclinical 
      acute kidney injury was detected in 321 patients (17%). Patients with subclinical 
      acute kidney injury had increased rate of the composite end point of adverse 
      in-hospital events (20.3% vs. 9.7%, p<0.001), a finding which was independent of 
      baseline renal function. Individual components of this end point (occurrence of 
      heart failure, atrial fibrillation, need for mechanical ventilation and 
      in-hospital mortality) were all significantly higher among patients with 
      subclinical acute kidney injury ( p< 0.05 for all). In a multivariable regression 
      model subclinical acute kidney injury was independently associated with higher 
      risk for adverse in-hospital events (odds ratio 1.92.6, 95% confidence interval: 
      1.23-2.97, p=0.004). CONCLUSIONS: Among STEMI patients treated with primary 
      percutaneous coronary intervention, small, subclinical elevations of serum 
      creatinine, while not fulfilling the consensus criteria for acute kidney injury, 
      may serve as a significant biomarker for adverse outcomes.
FAU - Margolis, Gilad
AU  - Margolis G
AD  - 1 Departments of Cardiology, Tel-Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel-Aviv University, Israel.
FAU - Gal-Oz, Amir
AU  - Gal-Oz A
AD  - 2 Departments of Nephrology, Tel-Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel-Aviv University, Israel.
FAU - Khoury, Shafik
AU  - Khoury S
AD  - 1 Departments of Cardiology, Tel-Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel-Aviv University, Israel.
FAU - Keren, Gad
AU  - Keren G
AD  - 1 Departments of Cardiology, Tel-Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel-Aviv University, Israel.
FAU - Shacham, Yacov
AU  - Shacham Y
AD  - 1 Departments of Cardiology, Tel-Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel-Aviv University, Israel.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20170615
PL  - England
TA  - Eur Heart J Acute Cardiovasc Care
JT  - European heart journal. Acute cardiovascular care
JID - 101591369
RN  - 0 (Biomarkers)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Acute Kidney Injury/*blood/epidemiology/etiology
MH  - Biomarkers/blood
MH  - Creatinine/*blood
MH  - Female
MH  - Glomerular Filtration Rate
MH  - Hospital Mortality/trends
MH  - Humans
MH  - Incidence
MH  - Israel/epidemiology
MH  - Male
MH  - Middle Aged
MH  - *Percutaneous Coronary Intervention
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/*complications/mortality/surgery
MH  - Survival Rate/trends
OTO - NOTNLM
OT  - Acute kidney injury
OT  - ST elevation myocardial infarction
OT  - percutaneous coronary intervention
OT  - serum creatinine
EDAT- 2017/06/16 06:00
MHDA- 2019/01/19 06:00
CRDT- 2017/06/16 06:00
PHST- 2017/06/16 06:00 [pubmed]
PHST- 2019/01/19 06:00 [medline]
PHST- 2017/06/16 06:00 [entrez]
AID - 10.1177/2048872617716389 [doi]
PST - ppublish
SO  - Eur Heart J Acute Cardiovasc Care. 2018 Dec;7(8):732-738. doi: 
      10.1177/2048872617716389. Epub 2017 Jun 15.