PMID- 29092921
OWN - NLM
STAT- MEDLINE
DCOM- 20190102
LR  - 20190102
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 104
IP  - 9
DP  - 2018 May
TI  - Contrast-induced acute kidney injury and mortality in ST elevation myocardial 
      infarction treated with primary percutaneous coronary intervention.
PG  - 767-772
LID - 10.1136/heartjnl-2017-311975 [doi]
AB  - OBJECTIVES: Contrast-induced acute kidney injury (CI-AKI) is a common and 
      potentially severe complication in patients with ST elevation myocardial 
      infarction (STEMI) treated with primary percutaneous coronary intervention 
      (pPCI). There is no consensus on the best definition of CI-AKI to identify 
      patients at risk of haemodialysis or death. The objective of this study was to 
      assess the association of CI-AKI, using four definitions, on inhospital 
      mortality, mortality or haemodialysis requirement over 1-year follow-up, in 
      patients with STEMI treated with pPCI. METHODS: In this prospective, 
      observational study, all patients with STEMI referred for pPCI were included. We 
      identified independent variables associated with CI-AKI and mortality. RESULTS: 
      We included 1114 consecutive patients with STEMI treated by pPCI. CI-AKI occurred 
      in 18.3%, 12.2%, 15.6% and 10.5% of patients according to the CIN, Acute Kidney 
      Injury Network (AKIN), Risk, Injury, Failure, Loss of kidney function, and 
      End-stage kidney disease (RIFLE) Modification of Diet in Renal Disease (MDRD) and 
      RIFLE Chronic Kidney Disease - Epidemiology Collaboration (CKD-EPI) definitions, 
      respectively. The RIFLE (CKD-EPI) definition was the most discriminant definition 
      to identify patients at higher risk of inhospital mortality (27.1% vs 4.0%; 
      adjusted OR 2.7 (95% CI 1.4 to 5.1), p=0.003), 1-year mortality (27.4% vs 6.6%; 
      adjusted OR 2.8 (95% CI 1.5 to 5.3), p=0.002) and haemodialysis requirement at 
      1-year follow-up (15.6% vs 2.7%; adjusted OR 6.7 (95% CI 3.3 to 13.6), p=0.001). 
      Haemodynamic instability, cardiac arrest, preexisting renal failure, elderly age 
      and a high contrast media volume were independently associated with 1-year 
      mortality. Of interest, contrast-media volume was not correlated to increase of 
      creatininaemia (r=0.06) or decrease in estimated glomerular filtration rate 
      (r=0.05) after percutaneous coronary intervention in our population. CONCLUSIONS: 
      CI-AKI is a frequent and serious complication of STEMI treated by pPCI. The RIFLE 
      definition is the most accurate definition to identify patients with CI-AKI at 
      high risk of mortality or haemodialysis.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of 
      the article) 2018. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Silvain, Johanne
AU  - Silvain J
AUID- ORCID: 0000-0002-1901-2808
AD  - ACTION Study Group, Sorbonne Universites - Univ Paris 6 (UPMC), INSERM UMRS 1166, 
      Institut de Cardiologie, Hopital Pitie-Salpetriere (AP-HP), Paris, France.
FAU - Nguyen, Lee S
AU  - Nguyen LS
AD  - ACTION Study Group, Sorbonne Universites - Univ Paris 6 (UPMC), INSERM UMRS 1166, 
      Institut de Cardiologie, Hopital Pitie-Salpetriere (AP-HP), Paris, France.
FAU - Spagnoli, Vincent
AU  - Spagnoli V
AD  - ACTION Study Group, Sorbonne Universites - Univ Paris 6 (UPMC), INSERM UMRS 1166, 
      Institut de Cardiologie, Hopital Pitie-Salpetriere (AP-HP), Paris, France.
FAU - Kerneis, Mathieu
AU  - Kerneis M
AD  - ACTION Study Group, Sorbonne Universites - Univ Paris 6 (UPMC), INSERM UMRS 1166, 
      Institut de Cardiologie, Hopital Pitie-Salpetriere (AP-HP), Paris, France.
FAU - Guedeney, Paul
AU  - Guedeney P
AD  - ACTION Study Group, Sorbonne Universites - Univ Paris 6 (UPMC), INSERM UMRS 1166, 
      Institut de Cardiologie, Hopital Pitie-Salpetriere (AP-HP), Paris, France.
FAU - Vignolles, Nicolas
AU  - Vignolles N
AD  - ACTION Study Group, Sorbonne Universites - Univ Paris 6 (UPMC), INSERM UMRS 1166, 
      Institut de Cardiologie, Hopital Pitie-Salpetriere (AP-HP), Paris, France.
FAU - Cosker, Kristel
AU  - Cosker K
AD  - Departement d'information medicale, Hopital Pitie-Salpetriere (AP-HP), Paris, 
      France.
FAU - Barthelemy, Olivier
AU  - Barthelemy O
AD  - ACTION Study Group, Sorbonne Universites - Univ Paris 6 (UPMC), INSERM UMRS 1166, 
      Institut de Cardiologie, Hopital Pitie-Salpetriere (AP-HP), Paris, France.
FAU - Le Feuvre, Claude
AU  - Le Feuvre C
AD  - ACTION Study Group, Sorbonne Universites - Univ Paris 6 (UPMC), INSERM UMRS 1166, 
      Institut de Cardiologie, Hopital Pitie-Salpetriere (AP-HP), Paris, France.
FAU - Helft, Gerard
AU  - Helft G
AD  - ACTION Study Group, Sorbonne Universites - Univ Paris 6 (UPMC), INSERM UMRS 1166, 
      Institut de Cardiologie, Hopital Pitie-Salpetriere (AP-HP), Paris, France.
FAU - Collet, Jean-Philippe
AU  - Collet JP
AD  - ACTION Study Group, Sorbonne Universites - Univ Paris 6 (UPMC), INSERM UMRS 1166, 
      Institut de Cardiologie, Hopital Pitie-Salpetriere (AP-HP), Paris, France.
FAU - Montalescot, Gilles
AU  - Montalescot G
AD  - ACTION Study Group, Sorbonne Universites - Univ Paris 6 (UPMC), INSERM UMRS 1166, 
      Institut de Cardiologie, Hopital Pitie-Salpetriere (AP-HP), Paris, France.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20171101
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - 0 (Contrast Media)
SB  - IM
MH  - Acute Kidney Injury/*chemically induced/mortality
MH  - Contrast Media/*adverse effects
MH  - Female
MH  - Heart Arrest/complications/mortality
MH  - Hospital Mortality
MH  - Humans
MH  - Kidney Failure, Chronic/complications/mortality
MH  - Male
MH  - Middle Aged
MH  - Percutaneous Coronary Intervention/*adverse effects/mortality
MH  - Prospective Studies
MH  - Renal Dialysis/mortality/statistics & numerical data
MH  - ST Elevation Myocardial Infarction/complications/mortality/*surgery
OTO - NOTNLM
OT  - acute coronary syndromes
OT  - acute myocardial infarction
OT  - percutaneous coronary intervention
COIS- Competing interests: JS has received research grants, honorarium or travel 
      support from Actelion, Amed, Amgen, Algorythm, Astra-Zeneca, Bayer, 
      Daiichi-Sankyo, Eli Lilly, Fondation de France, Gilead Science, IrokoCardio, 
      Sanofi-Aventis and Saint-Jude Medical. LSN has received research grants from 
      Federation Francaise de Cardiologie and Societe Francaise de Cardiologie. MK has 
      received research grants from Sanofi, Federation Francaise de Cardiologie, 
      Societe Francaise de Cardiologie, and lectures and consulting fees for ESC, 
      AstraZeneca, Daiichi-Sankyo and Bayer. PG has received research grants from 
      Federation Francaise de Cardiologie. GH has received research grants or 
      honorarium from Federation Francaise de Cardiologie, Cordis, Boston, Medtronic, 
      Terumo, Biotronik, AstraZeneca, Boehringer Ingelheim, Bayer, Bristol-Myer Squibb 
      and Sanofi-Aventis. JPC has received research grants or honorarium from 
      AstraZeneca, Bayer, Bristol-Myers Squibb, Daiichi-Sankyo, Eli-Lilly, Federation 
      Francaise de Cardiologie, Lead-Up, Medtronic, MSD, Sanofi-Aventis and WebMD. GM 
      has received research grants or honorarium from ADIR, Amgen, AstraZeneca, Bayer, 
      Berlin Chimie AG, Boehringer Ingelheim, Bristol-Myers Squibb, Beth Israel 
      Deaconess Medical, Brigham Women's Hospital, Cardiovascular Research Foundation, 
      Celladon, CME Resources, Daiichi-Sankyo, Eli-Lilly, Europa, Elsevier, Federation 
      Francaise de Cardiologie, Fondazione Anna Maria Sechi per il Cuore, Gilead, ICAN, 
      Janssen, Lead-Up, Menarini, Medtronic, MSD, Pfizer, Sanofi-Aventis, Servier, The 
      Medicines Company, TIMI Study Group and WebMD. Other authors have no conflicts of 
      interest to declare.
EDAT- 2017/11/03 06:00
MHDA- 2019/01/03 06:00
CRDT- 2017/11/03 06:00
PHST- 2017/06/06 00:00 [received]
PHST- 2017/10/16 00:00 [revised]
PHST- 2017/10/16 00:00 [accepted]
PHST- 2017/11/03 06:00 [pubmed]
PHST- 2019/01/03 06:00 [medline]
PHST- 2017/11/03 06:00 [entrez]
AID - heartjnl-2017-311975 [pii]
AID - 10.1136/heartjnl-2017-311975 [doi]
PST - ppublish
SO  - Heart. 2018 May;104(9):767-772. doi: 10.1136/heartjnl-2017-311975. Epub 2017 Nov 
      1.