Клиническая и экспериментальная кардиология
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Incidence and Prognostic Implications of Contrast-Induced Acute Kidney Injury Among Patients Undergoing Primary Percutaneous Coronary Intervention Due To ST-Elevation Myocardial Infarction.

Chunhui He

BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) has been associated with worse prognosis after percutaneous coronary intervention (PCI). We sought to assess the incidence and prognostic implications of CI-AKI among an all-comer population of patients who underwent primary PCI (pPCI) due to ST-elevation myocardial infarction (STEMI).

METHODS: Patients with STEMI who underwent pPCI with baseline and peak creatinine after PCI in the prospective, multicenter Chinese Acute Myocardial Infarction (CAMI) registry were included. CI-AKI was defined as a relative ≥1.5-fold increase in serum creatinine from baseline, or an absolute increase of ≥0.3 mg/dL. Major adverse cardiac event (MACE) was defined as the composite of all-cause death, myocardial infarction or stroke.

RESULTS: 5,205 patients were included since Jan 2013 to Feb 2018 from 108 PCI centers in China, 684 (13.14%) developed CI-AKI. Risk factors for developing CI-AKI included older age, female sex, time from onset of chest pain, Killip classification, and GP IIb/IIIa antagonist prescription. Patients with CI-AKI had higher unadjusted and adjusted risks of MACE and death both at 30 days and at one year (Table).

CONCLUSION: CI-AKI was relatively common after pPCI for STEMI, particularly among women and older patients. CI-AKI was an independent predictor of MACE and mortality both at 30 days and 1 year.