Vol 31, No 1 (2024)
Original Article
Published online: 2022-05-13

open access

Page views 1408
Article views/downloads 526
Get Citation

Connect on Social Media

Connect on Social Media

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
Pubmed: 35578758
Cardiol J 2024;31(1):53-61.

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.

Article available in PDF format

View PDF Download PDF file

References

  1. Mehran R, Dangas GD, Weisbord SD. Contrast-Associated Acute Kidney Injury. N Engl J Med. 2019; 380(22): 2146–2155.
  2. Marenzi G, Lauri G, Assanelli E, et al. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol. 2004; 44(9): 1780–1785.
  3. Goldberg A, Hammerman H, Petcherski S, et al. Inhospital and 1-year mortality of patients who develop worsening renal function following acute ST-elevation myocardial infarction. Am Heart J. 2005; 150(2): 330–337.
  4. Weisbord SD, Chen H, Stone RA, et al. Associations of increases in serum creatinine with mortality and length of hospital stay after coronary angiography. J Am Soc Nephrol. 2006; 17(10): 2871–2877.
  5. Zhang WF, Zhang T, Ding D, et al. Use of both serum cystatin c and creatinine as diagnostic criteria for contrast-induced acute kidney injury and its clinical implications. J Am Heart Assoc. 2017; 6(1).
  6. Mehta RL, Kellum JA, Shah SV, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007; 11(2): R31.
  7. Morcos SK, Thomsen HS, Webb JA. Contrast-media-induced nephrotoxicity: a consensus report. Contrast Media Safety Committee, European Society of Urogenital Radiology (ESUR). Eur Radiol. 1999; 9(8): 1602–1613.
  8. Centola M, Lucreziotti S, Salerno-Uriarte D, et al. A comparison between two different definitions of contrast-induced acute kidney injury in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Int J Cardiol. 2016; 210: 4–9.
  9. Lei Li, Xue Y, Guo Z, et al. A comparison between different definitions of contrast-induced acute kidney injury for long-term mortality in patients with acute myocardial infarction. Int J Cardiol Heart Vasc. 2020; 28: 100522.
  10. James MT, Samuel SM, Manning MA, et al. Associations between acute kidney injury and cardiovascular and renal outcomes after coronary angiography. Circulation. 2011; 123(4): 409–416.
  11. Maioli M, Toso A, Leoncini M, et al. Persistent renal damage after contrast-induced acute kidney injury: incidence, evolution, risk factors, and prognosis. Circulation. 2012; 125(25): 3099–3107.
  12. Pesarini G, Lunardi M, Ederle F, et al. Long-term (3 years) prognosis of contrast-induced acute kidney injury after coronary angiography. Am J Cardiol. 2016; 117(11): 1741–1746.
  13. Ungprasert P, Cheungpasitporn W, Crowson CS, et al. Individual non-steroidal anti-inflammatory drugs and risk of acute kidney injury: a systematic review and meta-analysis of observational studies. Eur J Intern Med. 2015; 26(4): 285–291.
  14. Hayward RS, Harding J, Molloy R, et al. Adverse effects of a single dose of gentamicin in adults: a systematic review. Br J Clin Pharmacol. 2018; 84(2): 223–238.
  15. Levey AS, Stevens LA. Estimating GFR using the CKD Epidemiology Collaboration (CKD-EPI) creatinine equation: more accurate GFR estimates, lower CKD prevalence estimates, and better risk predictions. Am J Kidney Dis. 2010; 55(4): 622–627.
  16. O’Gara P, Kushner F, Ascheim D, et al. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction. Circulation. 2013; 127(4).
  17. Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018; 39(2): 119–177.
  18. Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016; 29(4): 277–314.
  19. Shaw A. Models of preventable disease: contrast-induced nephropathy and cardiac surgery-associated acute kidney injury. Contrib Nephrol. 2011; 174: 156–162.
  20. Wald R, Quinn RR, Luo J, et al. Chronic dialysis and death among survivors of acute kidney injury requiring dialysis. JAMA. 2009; 302(11): 1179–1185.
  21. Chawla LS, Amdur RL, Shaw AD, et al. Association between AKI and long-term renal and cardiovascular outcomes in United States veterans. Clin J Am Soc Nephrol. 2014; 9(3): 448–456.
  22. Okusa MD, Molitoris BA, Palevsky PM, et al. Design of clinical trials in acute kidney injury: report from an NIDDK workshop on trial methodology. Clin J Am Soc Nephrol. 2012; 7(5): 844–850.
  23. Basile DP, Donohoe D, Roethe K, et al. Renal ischemic injury results in permanent damage to peritubular capillaries and influences long-term function. Am J Physiol Renal Physiol. 2001; 281(5): F887–F899.
  24. Coca SG, Singanamala S, Parikh CR. Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis. Kidney Int. 2012; 81(5): 442–448.
  25. Jabara R, Gadesam RR, Pendyala LK, et al. Impact of the definition utilized on the rate of contrast-induced nephropathy in percutaneous coronary intervention. Am J Cardiol. 2009; 103(12): 1657–1662.
  26. Narula A, Mehran R, Weisz G, et al. Contrast-induced acute kidney injury after primary percutaneous coronary intervention: results from the HORIZONS-AMI substudy. Eur Heart J. 2014; 35(23): 1533–1540.
  27. Shacham Y, Leshem-Rubinow E, Steinvil A, et al. Renal impairment according to acute kidney injury network criteria among ST elevation myocardial infarction patients undergoing primary percutaneous intervention: a retrospective observational study. Clin Res Cardiol. 2014; 103(7): 525–532.
  28. Silvain J, Nguyen LS, Spagnoli V, et al. Contrast-induced acute kidney injury and mortality in ST elevation myocardial infarction treated with primary percutaneous coronary intervention. Heart. 2018; 104(9): 767–772.
  29. Bellomo R, Ronco C, Kellum JA, et al. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004; 8(4): R204–R212.
  30. Silver SA, Shah PM, Chertow GM, et al. Risk prediction models for contrast induced nephropathy: systematic review. BMJ. 2015; 351: h4395.
  31. Chalikias G, Serif L, Kikas P, et al. Long-term impact of acute kidney injury on prognosis in patients with acute myocardial infarction. Int J Cardiol. 2019; 283: 48–54.
  32. Ishani A, Xue JL, Himmelfarb J, et al. Acute kidney injury increases risk of ESRD among elderly. J Am Soc Nephrol. 2009; 20(1): 223–228.
  33. Grams ME, Rabb H. The distant organ effects of acute kidney injury. Kidney Int. 2012; 81(10): 942–948.
  34. Weisbord SD, Palevsky PM, Kaufman JS, et al. Contrast-associated acute kidney injury and serious adverse outcomes following angiography. J Am Coll Cardiol. 2020; 75(11): 1311–1320.