Renal failure in patients with ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention: Predictors, clinical and angiographic features, and outcomes

• Published in: The American heart journal 2016-03, Vol.173, p.57-66
• Main Authors: Vavalle, John P., MD, MHS, van Diepen, Sean, MD, Clare, Robert M., MS, Hochman, Judith S., MD, Weaver, W. Douglas, MD, Mehta, Rajendra H., MD, Pieper, Karen S., MS, Patel, Manesh R., MD, Patel, Uptal D., MD, Armstrong, Paul W., MD, Granger, Christopher B., MD, Lopes, Renato D., MD, PhD
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Aged; Aged, 80 and over; Alberta - epidemiology; Angioplasty; Blood pressure; Cardiovascular; Clinical outcomes; Coronary Angiography; Creatinine - blood; Diabetes; Disease Progression; Double-Blind Method; Electrocardiography; Female; Follow-Up Studies; Glomerular Filtration Rate - physiology; Heart attacks; Heart failure; Hemodialysis; Humans; Incidence; Kidney diseases; Male; Middle Aged; Mortality; Myocardial infarction; Myocardial Infarction - complications; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - surgery; Patients; Percutaneous Coronary Intervention - methods; Prognosis; Renal failure; Renal function; Renal Insufficiency - diagnosis; Renal Insufficiency - epidemiology; Renal Insufficiency - etiology; Review boards; Risk Assessment; Risk Factors; Studies; Survival Rate - trends; Time Factors; United States - epidemiology
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2015.12.001

Background Among patients presenting with ST-segment elevation myocardial infarction (STEMI) for primary percutaneous coronary intervention (PCI), the associations between clinical outcomes and both baseline renal function and the development of acute kidney injury (AKI) have not been reported in a trial population with unselected baseline renal function. Methods Patients enrolled in the APEX-AMI trial who underwent primary PCI for the treatment of STEMI were categorized according to ( a ) baseline renal function and ( b ) the development of AKI. Patient characteristics, clinical outcomes, and treatment patterns were analyzed according to baseline renal function and the development of AKI. A prediction model for AKI after primary PCI for STEMI was also developed. Results A total of 5,244 patients were included in this analysis and stratified according to baseline estimated glomerular filtration rate (eGFR) (milliliters per minute per 1.73 m2 ) of >90, 60 to 90, 30 to 59, or 90, 60 to 90, 30 to 59, and