Predictors of acute kidney injury in patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock who underwent percutaneous coronary intervention

Abstract

Objective: to study predictors of acute kidney injury (AKI) in patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) who underwent percutaneous coronary intervention. Materials and methods: 109 patients with STEMI complicated by CS were studied after interventional intervention (mean age 63.1±10.1 years). The observation group included 33 patients with AKI, and the comparison group — 76 patients without AKI. AKI was diagnosed with an increase in plasma creatinine level by ≥26.5 mmol/l from the baseline level within 48 hours or by ≥1.5 times from its known or assumed basal level. To identify predictors of AKI, the method of simple and multiple logistic regression was used. Results: among patients with AKI, patients aged over 70 years (54.5% vs 15.8%, p<0.001), with concomitant chronic kidney disease (57.6% vs 26.3%, p=0.002), chronic heart failure with a low ejection fraction (69.7% vs 36.8%, p=0.001), an initial glomerular filtration rate of less than 60 ml/min/1.73 m2 (54.5% vs 22.4%, p=0.001) and a left ventricular ejection fraction below 40% (75.8% vs 51.3%, p=0.022) and a three-vascular lesion of the coronary arteries (63.6% vs 40.8%, p=0.028) were significantly more often observed. Conclusions: AKI in patients with STEMI complicated by CS after intracoronary intervention was associated with an age older than 70 years, the presence of a left ventricular ejection fraction of less than 40% and a glomerular filtration rate of less than 60 ml/min/1.73 m2.