Elevated serum uric acid is a predictor of contrast associated acute kidney injury in patient with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention |
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Authors: | Alessandro Mandurino-Mirizzi Vilma Kajana Stefano Cornara Alberto Somaschini Andrea Demarchi Marco Galazzi Gabriele Crimi Marco Ferlini Rita Camporotondo Massimiliano Gnecchi Maurizio Ferrario Luigi Oltrona-Visconti Gaetano M De Ferrari |
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Institution: | 1. Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy;2. University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy;3. Cardio-Thoraco-Vascular Department, Ospedale Policlinico San Martino IRCCS, Genova, Italy;4. Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy |
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Abstract: | BackgroundContrast associated-acute kidney injury (CA-AKI) has been associated with adverse outcomes after ST-segment elevation myocardial infarction (STEMI). However, early markers of CA-AKI are still needed to improve risk stratification. We investigated the association between elevated serum uric acid (eSUA) and CA-AKI in patients with STEMI treated with primary percutaneous coronary intervention (pPCI).Methods and resultsSerum creatinine (Scr) was measured at admission and 24, 48 and 72 h after pPCI. CA-AKI was defined as an increase of 25% (CA-AKI 25%) or 0.5 mg/dl (CA-AKI 0.5) of Scr level above the baseline after 48 h following contrast administration. Multivariable analyses to investigate CA-AKI predictors were performed by binary logistic regression and multivariable backward logistic regression model.In the 3023 patients considered, CA-AKI was more frequent among patients with eSUA as compared with patients with normal SUA levels, considering both CA-AKI definitions (CA-AKI25%: 20.8% vs 16.2%, p < 0.012; CA-AKI 0.5: 10.1% vs 5.8%, p < 0.001). The association between eSUA and CA-AKI was confirmed at multivariable analyses (CA-AKI 25%: odd ratio 1.32, 95% CI 1.03–1.69, p = 0.027; CA-AKI 0.5: odd ratio 1.76, 95% CI 1.11–2.79, p = 0.016).ConclusionElevated serum uric acid is associated with CA-AKI after reperfusion in patients with STEMI treated with pPCI. |
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Keywords: | Serum uric acid Contrast-associated acute kidney injury ST-segment myocardial infarction Percutaneous coronary intervention |
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