Transient vs In-Hospital Persistent Acute Kidney Injury in Patients With Acute Coronary Syndrome |
| |
| Affiliation: | 1. Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland;2. CTU Bern, University of Bern, Switzerland;3. University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy;4. Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Jessa Ziekenhuis, Hasselt, Belgium;5. Faculty of Medicine and Life Sciences, University of Hasselt, Hasselt, Belgium;6. Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Cona, Italy;7. Cardiology Unit, Ospedali Riuniti di Rivoli, ASL Torino 3, Turin, Italy;8. Cardiology Unit, Azienda Ospedaliera Universitaria San Luigi Gonzaga Orbassano, Turin, Italy;9. Division of Cardiology, “Sant’Anna e San Sebastiano” Hospital, Caserta, Italy;10. Department of Translational Medicine, University of Campania “Luigi Vanvitelli,” Caserta, Italy;11. Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy;12. Department of Cardiovascular Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy;13. Vimercate Hospital, ASST della Brianza, Italy;14. Azienda Ospedaliera Universitaria Policlinico “Gaetano Martino,” University of Messina, Messina, Italy;15. Cardiology Department, Misericordia Hospital, Grosseto, Italy;p. IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milano;q. Cardiology Unit, Infermi Hospital, Rimini, Italy;r. Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy;s. Cardiovascular Intervention Unit, San Giovanni Bosco Hospital, Turin, Italy;t. Hospital Clínic, Cardiovascular Clinic Institute, Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain;u. Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy;v. Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden;w. Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;x. Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland;y. Department of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland |
| |
| Abstract: | BackgroundThe occurrence of acute kidney injury (AKI) among patients with acute coronary syndrome (ACS) undergoing invasive management is associated with worse outcomes. However, the prognostic implications of transient or in-hospital persistent AKI may differ.ObjectivesThe aim of this study was to evaluate the prognostic implications of transient or in-hospital persistent AKI in patients with ACS.MethodsIn the MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial, 203 subjects were excluded because of incomplete information or end-stage renal disease, with a study population of 8,201 patients. Transient and persistent AKI were defined as renal dysfunction no longer or still fulfilling the AKI criteria (>0.5 mg/dL or a relative >25% increase in creatinine) at discharge, respectively. Thirty-day coprimary outcomes were the out-of-hospital composite of death, myocardial infarction, or stroke (major adverse cardiovascular events [MACE]) and net adverse cardiovascular events (NACE), defined as the composite of MACE or Bleeding Academic Research Consortium type 3 or 5 bleeding.ResultsPersistent and transient AKI occurred in 750 (9.1%) and 587 (7.2%) subjects, respectively. After multivariable adjustment, compared with patients without AKI, the risk for 30-day coprimary outcomes was higher in patients with persistent AKI (MACE: adjusted HR: 2.32; 95% CI: 1.48-3.64; P < 0.001; NACE: adjusted HR: 2.29; 95% CI: 1.48-3.52; P < 0.001), driven mainly by all-cause mortality (adjusted HR: 3.43; 95% CI: 2.03-5.82; P < 0.001), whereas transient AKI was not associated with higher rates of MACE or NACE. Results remained consistent when implementing the KDIGO (Kidney Disease Improving Global Outcomes) criteria.ConclusionsAmong patients with ACS undergoing invasive management, in-hospital persistent but not transient AKI was associated with higher risk for 30-day MACE and NACE. (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox [MATRIX]; NCT01433627) |
| |
| Keywords: | acute coronary syndrome percutaneous coronary intervention persistent acute kidney injury transient acute kidney injury ACS" },{" #name" :" keyword" ," $" :{" id" :" kwrd0035" }," $$" :[{" #name" :" text" ," _" :" acute coronary syndrome AKI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0045" }," $$" :[{" #name" :" text" ," _" :" acute kidney injury BARC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0055" }," $$" :[{" #name" :" text" ," _" :" Bleeding Academic Research Consortium CKD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0065" }," $$" :[{" #name" :" text" ," _" :" chronic kidney disease eGFR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0075" }," $$" :[{" #name" :" text" ," _" :" estimated glomerular filtration rate MACE" },{" #name" :" keyword" ," $" :{" id" :" kwrd0085" }," $$" :[{" #name" :" text" ," _" :" major adverse cardiovascular event(s) MI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0095" }," $$" :[{" #name" :" text" ," _" :" myocardial infarction NACE" },{" #name" :" keyword" ," $" :{" id" :" kwrd0105" }," $$" :[{" #name" :" text" ," _" :" net adverse clinical event(s) NSTEMI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0115" }," $$" :[{" #name" :" text" ," _" :" non-ST-segment elevation myocardial infarction PCI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0125" }," $$" :[{" #name" :" text" ," _" :" percutaneous coronary intervention SCr" },{" #name" :" keyword" ," $" :{" id" :" kwrd0135" }," $$" :[{" #name" :" text" ," _" :" serum creatinine UFH" },{" #name" :" keyword" ," $" :{" id" :" kwrd0145" }," $$" :[{" #name" :" text" ," _" :" unfractionated heparin |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
