Objective: To evaluate the clinical and prognostic relevance of acute kidney injury (AKI) in the setting of ST-elevation acute myocardial infarction (STEMI) complicated by cardiogenic shock (CS). Design: Prospective study. Setting: Single-center study, 13-bed intensive cardiac care unit at a University Cardiological Center. Patients: Ninety-seven consecutive STEMI patients with CS at admission, undergoing intra-aortic balloon pump (IABP) support and primary percutaneous coronary intervention (PCI). Interventions: None. Measurements and Main Results: We measured serum creatinine at baseline and each day for the following 3 days. Acute kidney injury was defined as a rise in creatinine >25% from baseline. Overall, AKI occurred in 52 (55%) patients, and in 12 of these patients, a renal replacement therapy was required. In multivariate analysis, age >75 yrs (p = .005), left ventricular ejection fraction ≤40% (p = .009), and use of mechanical ventilation (p = .01) were independent predictors of AKI. Patients developing AKI had a longer hospital stay, a more complicated clinical course, and significantly higher mortality rate (50% vs. 2.2%; p <.001) than patients without AKI. In our population, AKI was the strongest independent predictor of in-hospital mortality (relative risk 12.3, 95% confidence intervals 1.78 to 84.9; p <.001). Conclusions: In patients with STEMI complicated by CS, AKI represents a frequent clinical complication associated with a poor prognosis
Acute kidney injury in ST-segment elevation acute myocardial infarction complicated by cardiogenic shock at admission / G. Marenzi, E. Assanelli, J. Campodonico, M. De Metrio, G. Lauri, I. Marana, M. Moltrasio, M. Rubino, F. Veglia, P. Montorsi, A. Bartorelli. - In: CRITICAL CARE MEDICINE. - ISSN 0090-3493. - 38:2(2010 Feb), pp. 438-444.
|Titolo:||Acute kidney injury in ST-segment elevation acute myocardial infarction complicated by cardiogenic shock at admission|
|Settore Scientifico Disciplinare:||Settore MED/11 - Malattie dell'Apparato Cardiovascolare|
|Data di pubblicazione:||feb-2010|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1097/CCM.0b013e3181b9eb3b|
|Appare nelle tipologie:||01 - Articolo su periodico|