Heart and kidney crosstalk: risk factors, clinical features, and short-term outcomes associated with acute kidney injury in patients suffering acute non-ST elevation myocardial infarction.

Q2 Medicine

Medicinski Glasnik Pub Date : 2025-01-01 DOI:10.17392/1776-22-01

Minela Bećirović, Emir Bećirović, Semir Hadžić, Lejla Rakovac Tupković, Amir Bećirović, Nadina Avdić Jahić, Aida Ribić, Lamija Ferhatbegović, Amira Jagodić Ejubović, Emir Begagić, Daniela Lončar, Kenana Ljuca

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引用次数: 0

Abstract

Aim: Acute kidney injury (AKI) presents a high mortality complication in patients with acute myocardial infarction (AMI). Yet, its correlation with non-ST elevation myocardial infarction (NSTEMI) remains neglected in the literature. This study aims to investigate the prevalence, risk factors, clinical features, and short-term outcomes associated with AKI development in patients with acute NSTEMI.

Methods: A one-year prospective observational cohort study involved 170 consecutive patients hospitalized in the Intensive Care Department of the Internal Medicine Clinic at the University Clinical Centre Tuzla diagnosed with acute NSTEMI. Patients were subsequently categorized into AKI and non-AKI groups based on AKI development within 48 hours. Demographic characteristics, laboratory findings, and short-term clinical outcomes were compared between the groups.

Results: Of 170 patients, 31 (18.2%) developed AKI within 48 hours of acute NSTEMI. Significant age differences, blood urea nitrogen (BUN), creatinine, estimated glomerular filtration rate (eGFR), blood glucose level (BGL), C-reactive protein (CRP), and high sensitivity (hs) troponin were observed, making patients with lower baseline kidney function, more extensive myocardial infarction, and a heavier systemic inflammatory response following acute NSTEMI more susceptible to AKI development. In the follow-up period, mortality rates were significantly higher in the AKI group, amounting to 35.5% compared to 10.1% in the non-AKI group. Additionally, mortality increased with the severity of AKI, reaching 100% in AKI stage 2.

Conclusion: This study highlights demographic, clinical and laboratory findings in patients with acute NSTEMI, which contribute to AKI development. Early detection and tailored interventions are crucial in mitigating AKI-associated morbidity and mortality.

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心肾串扰：急性非ST段抬高型心肌梗死患者急性肾损伤的相关风险因素、临床特征和短期疗效。

目的：急性肾损伤（AKI）是急性心肌梗死（AMI）患者中死亡率较高的并发症。然而，其与非 ST 段抬高型心肌梗死（NSTEMI）的相关性在文献中仍被忽视。本研究旨在探讨急性 NSTEMI 患者发生 AKI 的患病率、风险因素、临床特征和短期预后：这项为期一年的前瞻性观察性队列研究涉及图兹拉大学临床中心内科诊所重症监护部连续住院的 170 名急性 NSTEMI 患者。随后，根据患者在 48 小时内出现 AKI 的情况将其分为 AKI 组和非 AKI 组。对两组患者的人口统计学特征、实验室检查结果和短期临床结果进行了比较：在170名患者中，有31人（18.2%）在急性NSTEMI发生48小时内出现了AKI。在年龄、血尿素氮 (BUN)、肌酐、估计肾小球滤过率 (eGFR)、血糖水平 (BGL)、C 反应蛋白 (CRP) 和高敏肌钙蛋白 (hs) 方面均存在显著差异，因此基线肾功能较低、心肌梗死范围更广、急性 NSTEMI 后全身炎症反应更重的患者更容易发生 AKI。在随访期间，AKI 组的死亡率明显较高，达到 35.5%，而非 AKI 组为 10.1%。此外，死亡率随着 AKI 的严重程度而增加，AKI 2 期的死亡率高达 100%：本研究强调了急性 NSTEMI 患者的人口统计学、临床和实验室检查结果，这些都是导致 AKI 发生的原因。早期发现和有针对性的干预对于降低与 AKI 相关的发病率和死亡率至关重要。

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

Medicinski Glasnik 医学-医学：内科

CiteScore

2.30

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Medicinski Glasnik (MG) is the official publication (two times per year) of the Medical Association of Zenica-Doboj Canton. Manuscripts that present of original basic and applied research from all fields of medicine (general and clinical practice, and basic medical sciences) are invited.