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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Shacham, Yacov Leshem-Rubinow, Eran Gal-Oz, Amir Arbel, Yaron Keren, Gad Roth, Arie Steinvil, Arie |
| Spatial Coverage | Israel |
| Description | Author Affiliation: Shacham Y ( Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: kobyshacham@gmail.com.); Leshem-Rubinow E ( Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.); Gal-Oz A ( Department of Nephrology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.); Arbel Y ( Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.); Keren G ( Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.); Roth A ( Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.); Steinvil A ( Department of Cardiology, Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.) |
| Abstract | BACKGROUND: Early hemodynamic impairment frequently complicates myocardial injury, however, limited data are present regarding its direct association with acute kidney injury (AKI) after ST segment elevation myocardial infarction (STEMI) in patients who undergo primary percutaneous coronary intervention (PCI). We evaluated the effect of acute hemodynamic derangement on the risk of AKI among STEMI patients who undergo primary PCI. METHODS: We performed a retrospective analysis of 1656 consecutive patients admitted with the diagnosis of STEMI between January 2008 and December 2014, and treated with primary PCI. Medical records were reviewed for the presence of various clinical parameters of hemodynamic derangement and for the occurrence of AKI. RESULTS: Mean age was 61 ± 13 and 1329 (80%) were men. AKI occurred in 168 patients (10%). Patients with AKI were older, of female sex, with more comorbidities, had longer time to reperfusion, and were more likely to have hemodynamic impairment including critical state, congestive heart failure, life-threatening arrhythmias, and worse left ventricular function (P < 0.001 for all). In a multivariate logistic regression model critical state (odds ratio [OR], 3.33; 95% confidence interval [CI], 1.39-7.8; P = 0.006), reduced left ventricular ejection fraction (OR, 0.95; 95% CI, 0.92-0.99; P = 0.03), congestive heart failure (OR, 2.34; 95% CI, 1.02-5.39; P = 0.04), and a trend for time to coronary reperfusion (OR, 1.01; 95% CI, 1.00-1.01; P = 0.07) emerged as independent predictors of AKI. CONCLUSIONS: Among STEMI patients who underwent primary PCI AKI should not be assumed to be solely contrast-induced nephropathy and acute hemodynamic abnormalities should be considered. |
| File Format | HTM / HTML |
| ISSN | 0828282X |
| Issue Number | 10 |
| Volume Number | 31 |
| e-ISSN | 19167075 |
| Journal | Canadian Journal of Cardiology |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2015-10-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Cardiology Myocardial Infarction Percutaneous Coronary Intervention Adverse Effects Acute Kidney Injury Diagnosis Epidemiology Etiology Age Factors Aged Cardio-renal Syndrome Comorbidity Female Hemodynamics Humans Israel Kidney Function Tests Methods Male Middle Aged Complications Therapy Prognosis Risk Assessment Risk Factors Time Factors Journal Article Observational Study |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cardiology and Cardiovascular Medicine |
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