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Year : 2019  |  Volume : 9  |  Issue : 1  |  Page : 24-27

Relationship between angiographic outcomes and occurrence of acute kidney injury in st-segment elevation myocardial infarction patients treated by primary percutaneous coronary intervention

Department of Cardiology, Ainshams University, Cairo, Egypt

Correspondence Address:
Dr. Mohamed Zahran
Doctor Mohamed Zahran's Cardiology Clinic, 3 Abdelazeem Awadallah Street, Higaz Square, Heliopolis, 11786 Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JICC.JICC_3_19

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Introduction: Acute kidney injury (AKI) complicates 7%–10% of the cases of critically ill patients; several studies found a similar incidence among ST-segment elevation myocardial infarction (STEMI) patients, especially those complicated by cardiogenic shock. Primary percutaneous coronary intervention (PPCI) is the gold standard treatment for STEMI patients, and using contrast during the procedure is mandatory and inevitably increases the risk of development of AKI. AKI complicating STEMI is associated with poor long-term clinical outcomes with mortality reaching nearly one-third of the affected patients. Patients and Methods: This study included 110 STEMI patients treated by PPCI presented to our Cath lab at Ainshams university hospitals (a 24/7 Tertiary Referral Center for PPCI) during the period between February 2014 and May 2015. The patients with impaired kidney functions, chronic kidney disease, and those on hemodialysis were excluded from the study. Results: AKI was defi ned as an increase of ≥0.3 mg/dL in serum creatinine within 48 h after admission. Eleven patients (10%) developed AKI. The presenting hemodynamics were worse in the patients complicated by AKI (systolic blood pressure 80 ± 35 mmHg vs. 105 ± 60 mmHg, P < 0.001). The pain-to-door time was signifi cantly higher in the patients that developed AKI (156 ± 68 min vs. 114 ± 53, P < 0.001). The volume of contrast was signifi cantly higher in the patients that developed AKI (192 ± 54 ml vs. 128 ± 63 ml, P < 0.001). The patients that developed AKI were signifi cantly more likely to have multivessel affection during their PPCI (5/11 [45.5%] vs. 16/99 [16.2%], P < 0.001), anterior wall location of the infarction (7/11 [63.6%] vs. 40/99 [40.4%], P < 0.001), and no-refl ow phenomenon (5/11 [45.5%] vs. 21/99 [21.2%], P < 0.001). Conclusions: Multivessel affection in PPCI patients, anterior wall location of the infarction and no-reflow phenomenon were significantly associated with occurrence of acute kidney injury in STEMI patients undergoing PPCI.

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