The prevalence and prognosis of contrast-induced acute kidney injury according to the definition in patients with acute myocardial infarction who underwent primary percutaneous coronary intervention

Clinical trials and regulatory science in cardiology Pub Date : 2016-01-01 DOI:10.1016/j.ctrsc.2015.11.004

Osamu Kuboyama , Takeshi Tokunaga

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引用次数: 5

Abstract

Background

Contrast-induced acute kidney injury (CI-AKI) is associated with adverse outcomes. However, the problem complicating CI-AKI relates to its definition. More than 30 definitions of AKI have been used in the literature. We examined the prevalence of CI-AKI according to three criteria. Prevalence of cardiovascular events according to each criterion was also investigated.

Methods

We studied 247 consecutive patients with acute myocardial infarction (66.7 ± 9.0 years, 189 males) who underwent primary percutaneous coronary intervention in our hospital. Three definitions of CI-AKI were applied: (i) traditional CI-AKI, (ii) CI-AKI derived from RIFLE criteria, (iii) CI-AKI derived from AKIN criteria. Cardiovascular events comprised in-hospital death, sudden death, cerebral infarction, heart failure, and acute coronary syndrome.

Results

Prevalence of CI-AKI was 27.1% (67/247) according to the traditional CI-AKI definition, 23.9% (59/247) according to the CI-AKI definition derived from RIFLE criteria, and 15.8% (39/247) according to the CI-AKI definition derived from AKIN criteria. Prevalence of cardiovascular events was 13.8% (34/247). Prevalence of cardiovascular events with and without CI-AKI was 19.4% (13/67) and 11.7% (21/180) according to the traditional CI-AKI definition (P = 0.13), 22.0% (13/59) and 11.2% (21/188) in the CI-AKI definition derived from RIFLE criteria (P = 0.035), and 35.9%(14/39) and 9.6% (20/208) according to the CI-AKI derived from AKIN criteria (P = 0.00001).

Conclusion

Prevalence of CI-AKI varies widely depending on the criteria used. The CI-AKI definition derived from AKIN criteria was the most effective predictor of cardiovascular events.

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急性心肌梗死患者经皮冠状动脉介入治疗后造影剂所致急性肾损伤的发生率及预后

造影剂诱导的急性肾损伤(CI-AKI)与不良结局相关。然而，使CI-AKI复杂化的问题与它的定义有关。文献中有30多种AKI的定义。我们根据三个标准检查了CI-AKI的患病率。根据每个标准还调查了心血管事件的发生率。方法对247例急性心肌梗死患者(66.7±9.0岁，男性189例)进行初步经皮冠状动脉介入治疗。采用了三种CI-AKI定义:(i)传统CI-AKI， (ii)从RIFLE标准衍生的CI-AKI， (iii)从AKIN标准衍生的CI-AKI。心血管事件包括院内死亡、猝死、脑梗死、心力衰竭和急性冠状动脉综合征。结果按传统CI-AKI定义CI-AKI患病率为27.1%(67/247)，按RIFLE定义CI-AKI患病率为23.9%(59/247)，按AKIN定义CI-AKI患病率为15.8%(39/247)。心血管事件发生率为13.8%(34/247)。根据传统CI-AKI定义，伴有和不伴有CI-AKI的心血管事件发生率分别为19.4%(13/67)和11.7% (21/180)(P = 0.13)，根据RIFLE标准定义的CI-AKI发生率分别为22.0%(13/59)和11.2% (21/188)(P = 0.035)，根据AKIN标准定义的CI-AKI发生率分别为35.9%(14/39)和9.6% (20/208)(P = 0.00001)。结论不同标准的CI-AKI患病率差异很大。基于AKIN标准的CI-AKI定义是心血管事件最有效的预测因子。

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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Clinical trials and regulatory science in cardiology

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