PMID- 29432373
OWN - NLM
STAT- MEDLINE
DCOM- 20190416
LR  - 20190416
IS  - 1535-2811 (Electronic)
IS  - 1535-2811 (Linking)
VI  - 17
IP  - 1
DP  - 2018 Mar
TI  - Contrast-Induced Nephropathy in STEMI Patients With and Without Chronic Kidney 
      Disease.
PG  - 25-31
LID - 10.1097/HPC.0000000000000123 [doi]
AB  - INTRODUCTION: Contrast-induced nephropathy (CIN) following percutaneous coronary 
      intervention (PCI) is associated with adverse outcomes; however, there are scarce 
      data comparing clinical outcomes of post-PCI CIN in ST elevation myocardial 
      infarction (STEMI) patients with and without chronic kidney disease (CKD). We 
      sought to assess the incidence, clinical predictors, and short-term and long-term 
      clinical outcomes of post-PCI CIN in STEMI patients with and without CKD. 
      METHODS: We performed a retrospective observational cohort study involving 554 
      patients who underwent PCI for STEMI from February 2010 to November 2013. CKD was 
      defined as estimated glomerular filtration rate </=60 mL/min and CIN as creatinine 
      increase by >/=25% or >/=0.5 mg/dL from baseline within 72 hours after 
      catheterization contrast exposure. RESULTS: In the entire population, CIN 
      developed in 89 (16%) patients. The incidence of CIN was 19.7% (27/137) in CKD 
      patients and 11.1% (62/417) in non-CKD patients, P < 0.05. Univariate analysis 
      predictors of CIN were older age (65 vs. 60 years), diabetes (35% vs. 21%), 
      peripheral artery disease (11% vs. 5%), cardiogenic shock (24% vs. 13%), 
      hemodynamic support placement (34% vs. 14%), and Mehran score (9.4 +/- 7 vs. 
      5.4 +/- 5.2) with all P < 0.05. The predictors of CIN were the same across the CKD 
      and non-CKD cohort with the exception of diabetes. In multivariate analysis, the 
      strongest predictor of CIN in CKD patients was diabetes (odds ratio, 5.8; CI, 
      1.8-18.6); however, diabetes was not a predictor in the non-CKD population. In 
      the non-CKD population, each single unit increase in the Mehran score was 
      associated with a 1.1 times greater likelihood of CIN (odds ratio, 1.1; CI, 
      1.01-1.2). Patients with CIN had higher rates of inpatient mortality (14.6% vs. 
      2.8%), longer length of hospitalization (8 +/- 11 vs. 3.4 +/- 4.4 days), need for 
      inpatient dialysis (11.2% vs. 0%), higher 30-day mortality (14.6% vs. 3.0%), and 
      higher incidence of long-term serum creatinine >0.5 mg/dL from baseline (16.9% 
      vs. 2.4%) with all P < 0.05. CONCLUSIONS: Overall, we found that CKD patients 
      undergoing PCI for STEMI have a higher incidence of CIN than non-CKD patients. 
      CIN confers worse short-term and long-term outcomes irrespective of baseline 
      renal function.
FAU - Jain, Tarun
AU  - Jain T
FAU - Shah, Sunay
AU  - Shah S
FAU - Shah, Jainil
AU  - Shah J
FAU - Jacobsen, Gordon
AU  - Jacobsen G
FAU - Khandelwal, Akshay
AU  - Khandelwal A
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Crit Pathw Cardiol
JT  - Critical pathways in cardiology
JID - 101165286
RN  - 0 (Contrast Media)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Acute Kidney Injury/blood/*chemically induced/epidemiology/therapy
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Catheterization
MH  - Case-Control Studies
MH  - Comorbidity
MH  - Contrast Media/*adverse effects
MH  - Coronary Angiography
MH  - Creatinine/blood
MH  - Diabetes Mellitus/epidemiology
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Incidence
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Percutaneous Coronary Intervention
MH  - Peripheral Arterial Disease/epidemiology
MH  - Renal Dialysis
MH  - Renal Insufficiency, Chronic/blood/epidemiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/epidemiology/*surgery
MH  - Shock, Cardiogenic/epidemiology
EDAT- 2018/02/13 06:00
MHDA- 2019/04/17 06:00
CRDT- 2018/02/13 06:00
PHST- 2018/02/13 06:00 [entrez]
PHST- 2018/02/13 06:00 [pubmed]
PHST- 2019/04/17 06:00 [medline]
AID - 00132577-201803000-00005 [pii]
AID - 10.1097/HPC.0000000000000123 [doi]
PST - ppublish
SO  - Crit Pathw Cardiol. 2018 Mar;17(1):25-31. doi: 10.1097/HPC.0000000000000123.