Predictors of contrast-induced acute kidney injury in hemodynamically stable patients with myocardial infarction
https://doi.org/10.33667/2078-5631-2022-9-31-35
Abstract
The aim. To study predictors of contrast-induced acute kidney injury (CI-AKI) in hemodynamically stable patients with myocardial infarction (MI).
Materials and methods. 487 hemodynamically stable patients with MI were under observation after emergency percutaneous coronary intervention (PCI). CI-AKI was defined as an increase in the level of creatinine in the blood within 48 hours after administration of the radiopaque drug (RCP) by ≥ 26.5 mmol from the baseline level. To detect independent risk factors of CI-AKI, the method of multiple logistic regression was used.
Results. The observation group consisted of 48 patients with MI who developed CI-AKI (mean age 64.2 ± 5.18 years), the comparison group of 439 patients with MI without CI-AKI (mean age 55.6 ± 6.03 years). In the observation group were observed more often patients older than 70 years (13 [27.1 %] vs 29 [13.4 %]; p = 0.011), with arterial hypertension (45 [93.8 %] vs 329 [74.9 %]; p = 0.003), postinfarction cardiosclerosis (18 [37.5 %] vs 98 [22.3 %]; p = 0.019), glycemic level ≥ 6.1 mmol/l at admission (22 [45.8 %] vs 129 [29.4 %]; p = 0.019) and left ventricular ejection fraction ≤ 40 % (14 [29.2 %] vs 71 [16.2 %]; p = 0.024). In patients with CI-AKI, the frequency of three vascular pathologies of the coronary bed was higher (29 [60.4 %] vs 195 [44.4 %]; p = 0.035), two or more stents were implanted more often in PCI (31 [64.6 %] vs 184 [41.9 %]; p = 0.003) and the volume of сontrast volume ≥ 145 ml was used (30 [62.5 %] vs 206 [46.9 %]; p = 0.040).
Findings. The probability of CI-AKI in hemodynamically stable MI patients was associated with the level of glucose in venous blood at admission ≥ 6.1 mmol/l, the сontrast volume used ≥ 145 ml and implantation of two or more stents in emergency PCI.
About the Author
O. V. Arsenicheva
Ivanovo State Medical Academy
Russian Federation
Russian Federation
Arsenicheva Olga V., PhD Med, associate professor at Dept of Internal Diseases and Phthisiology
Ivanovo
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Review
For citations:
Arsenicheva O.V. Predictors of contrast-induced acute kidney injury in hemodynamically stable patients with myocardial infarction. Medical alphabet. 2022;(9):31-35. (In Russ.) https://doi.org/10.33667/2078-5631-2022-9-31-35
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