Impact of Contrast-Associated Acute Kidney Injury on One-Year Outcomes in Very Elderly STEMI Patients: Insights From a Multicenter Registry in Northern Italy.

IF 2.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Angiology Pub Date : 2025-10-01 Epub Date: 2024-02-20 DOI:10.1177/00033197241233771
Alessandro Ruzzarin, Simone Muraglia, Enrico Fabris, Giorgio Caretta, Filippo Zilio, Andrea Pezzato, Gianluca Campo, Matthias Unterhuber, Luca Donazzan
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引用次数: 0

Abstract

Data about contrast-associated acute kidney injury (CA-AKI) in oldest old (age ≥85 years) ST-elevation myocardial infarction (STEMI) patients are scarce. We evaluated the incidence and the 1-year prognostic impact of CA-AKI in this population. Patients were included in a multicenter real-world registry, and CA-AKI was defined according to KDIGO (Kidney Disease Improving Global Outcomes) criteria. Major adverse cardiac and cerebrovascular events (MACCEs) were defined as the composite of all-cause death, stroke, unplanned coronary revascularization, and heart failure hospitalization. The primary outcome was the incidence and impact of CA-AKI on MACCEs at 1 year follow-up. Out of 461 STEMI patients (mean age 88.6 ± 2.9 years), 102 (22.1%) patients developed CA-AKI. Chronic kidney disease was the strongest predictor of CA-AKI (odds ratio [OR]: 4.52, 95% CI: 2.81-7.30, P < .01). The CA-AKI cohort showed a higher risk of MACCEs (adjusted HR: 1.75, 95% CI: 1.13-2.71, P = .01), driven mainly by all-cause death (adjusted hazard ratio [HR]: 2.39, 95% CI: 1.41-4.07, P = .01) and followed by heart failure hospitalization (adjusted HR: 2.01, 95% CI: 1.08-3.76, P = .01). Among oldest old STEMI, CA-AKI was frequent and associated with a higher incidence of MACCEs at 1-year follow-up.

对比度相关急性肾损伤对高龄 STEMI 患者一年预后的影响:意大利北部多中心登记的启示。
有关高龄(年龄≥85 岁)ST 段抬高型心肌梗死(STEMI)患者造影剂相关性急性肾损伤(CA-AKI)的数据很少。我们评估了这一人群中 CA-AKI 的发生率和 1 年预后影响。患者被纳入一个多中心真实世界登记处,CA-AKI 根据 KDIGO(肾病改善全球预后)标准定义。主要心脏和脑血管不良事件(MACCE)被定义为全因死亡、中风、非计划性冠状动脉血运重建和心衰住院的综合结果。主要结果是随访一年时 CA-AKI 的发生率及其对 MACCEs 的影响。在 461 名 STEMI 患者(平均年龄为 88.6 ± 2.9 岁)中,有 102 人(22.1%)发生了 CA-AKI。慢性肾病是预测 CA-AKI 的最有力因素(几率比 [OR]:4.52,95% CI:2.81-7.30,P < .01)。CA-AKI 队列显示出更高的 MACCE 风险(调整后 HR:1.75,95% CI:1.13-2.71,P = .01),主要由全因死亡驱动(调整后危险比 [HR]:2.39,95% CI:1.41-4.07,P = .01),其次是心衰住院(调整后 HR:2.01,95% CI:1.08-3.76,P = .01)。在年龄最大的 STEMI 患者中,CA-AKI 的发生率较高,随访 1 年后 MACCE 的发生率也较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Angiology
Angiology 医学-外周血管病
CiteScore
5.50
自引率
14.30%
发文量
180
审稿时长
6-12 weeks
期刊介绍: A presentation of original, peer-reviewed original articles, review and case reports relative to all phases of all vascular diseases, Angiology (ANG) offers more than a typical cardiology journal. With approximately 1000 pages per year covering diagnostic methods, therapeutic approaches, and clinical and laboratory research, ANG is among the most informative publications in the field of peripheral vascular and cardiovascular diseases. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 13 days
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