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Ahead of print
Original Article
Submitted: 2021-10-04
Accepted: 2022-05-04
Published online: 2022-05-13
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Predictive value of two different definitions of contrast-associated acute kidney injury for long-term major adverse kidney events in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Lian Chen1, Xiaolei Wang, Qianyun Wang2, Ding Ding3, Wenlong Jiang4, Zhengwen Ruan1, Weifeng Zhang2
DOI: 10.5603/CJ.a2022.0034
·
Pubmed: 35578758
Affiliations
  1. Department of Cardiology, Yuyao People’s Hospital of Zhejiang Province, Yuyao, Ningbo, Zhejiang, China
  2. Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
  3. Johns Hopkins School of Medicine, Baltimore, MD, United States
  4. Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

open access

Ahead of print
Original articles
Submitted: 2021-10-04
Accepted: 2022-05-04
Published online: 2022-05-13

Abstract

Background: It remains controversial whether contrast-associated acute kidney injury (CA-AKI) is associated with long-term major adverse kidney events (MAKE) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: By the Acute Kidney Injury Network (AKIN) criteria, CA-AKI was defined as an increase in serum creatinine ≥ 0.3 mg/dL or 50% from baseline within 48 h after PCI; or an increase in serum creatinine ≥ 0.5 mg/dL or 25% within 72 h by the contrast-induced nephropathy (CIN) criteria. The primary endpoint was 1-year MAKE, defined as a composite of all-cause mortality and persistent renal dysfunction. Results: A total of 402 patients were finally included in this study. The primary endpoint occurred in 29 (7.2%) patients. There was a significant association between CA-AKI and 1-year MAKE assessed by both the AKIN (hazard ratios [HR]: 11.58, 95% confidence interval [CI]: 4.29–31.24, p = 0.000) and CIN (HR: 6.45, 95% CI: 2.56–16.25, p = 0.000) definitions. However, the AKIN definition (HR: 4.95, 95% CI: 1.17–21.02, p = 0.030) was more reliable in the prediction of persistent renal dysfunction than CIN definition (HR: 4.08, 95% CI: 0.99–16.87, p = 0.052). Additionally, the area under receiver operating characteristic curve was larger for predicting 1-year MAKE with the AKIN definition than CIN definition (0.742 vs. 0.727). Conclusions: In patients with STEMI undergoing primary PCI, CA-AKI was significantly associated with 1-year MAKE. Moreover, the AKIN definition might be more reliable in the prediction of long-term prognosis.

Abstract

Background: It remains controversial whether contrast-associated acute kidney injury (CA-AKI) is associated with long-term major adverse kidney events (MAKE) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: By the Acute Kidney Injury Network (AKIN) criteria, CA-AKI was defined as an increase in serum creatinine ≥ 0.3 mg/dL or 50% from baseline within 48 h after PCI; or an increase in serum creatinine ≥ 0.5 mg/dL or 25% within 72 h by the contrast-induced nephropathy (CIN) criteria. The primary endpoint was 1-year MAKE, defined as a composite of all-cause mortality and persistent renal dysfunction. Results: A total of 402 patients were finally included in this study. The primary endpoint occurred in 29 (7.2%) patients. There was a significant association between CA-AKI and 1-year MAKE assessed by both the AKIN (hazard ratios [HR]: 11.58, 95% confidence interval [CI]: 4.29–31.24, p = 0.000) and CIN (HR: 6.45, 95% CI: 2.56–16.25, p = 0.000) definitions. However, the AKIN definition (HR: 4.95, 95% CI: 1.17–21.02, p = 0.030) was more reliable in the prediction of persistent renal dysfunction than CIN definition (HR: 4.08, 95% CI: 0.99–16.87, p = 0.052). Additionally, the area under receiver operating characteristic curve was larger for predicting 1-year MAKE with the AKIN definition than CIN definition (0.742 vs. 0.727). Conclusions: In patients with STEMI undergoing primary PCI, CA-AKI was significantly associated with 1-year MAKE. Moreover, the AKIN definition might be more reliable in the prediction of long-term prognosis.

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Keywords

contrast-associated acute kidney injury, definition, prediction, prognosis, major adverse kidney events

About this article
Title

Predictive value of two different definitions of contrast-associated acute kidney injury for long-term major adverse kidney events in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2022-05-13

Page views

956

Article views/downloads

304

DOI

10.5603/CJ.a2022.0034

Pubmed

35578758

Keywords

contrast-associated acute kidney injury
definition
prediction
prognosis
major adverse kidney events

Authors

Lian Chen
Xiaolei Wang
Qianyun Wang
Ding Ding
Wenlong Jiang
Zhengwen Ruan
Weifeng Zhang

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