Acute renal impairment in older adults treated with percutaneous coronary intervention for ST-segment elevation myocardial infarction.
Coron Artery Dis
; 30(8): 564-568, 2019 Dec.
Article
de En
| MEDLINE
| ID: mdl-30973353
ABSTRACT
BACKGROUND:
Elderly individuals ( ≥ 75 years) constitute an increasing proportion of patients presenting with myocardial infarction treated with primary percutaneous coronary intervention (PCI), but only limited data are available regarding the incidence and prognostic implications of acute kidney injury (AKI) in this group of patients.OBJECTIVE:
To evaluate the incidence and prognostic implications of AKI in older adults ( ≥ 75 years) with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI. PATIENTS ANDMETHODS:
A retrospective cohort, observational, single-center study of consecutive 416 older patients with STEMI (≥ 75 years) treated with primary PCI between January 2008 and August 2017 was conducted. AKI was defined as an increase of at least 0.3 mg/dl in serum creatinine within 48 h following admission.RESULTS:
A total of 96/416 (23%) patients developed AKI. The occurrence of AKI was associated with adverse in-hospital outcomes, higher 30 days (25 vs. 6%; P < 0.001), and long-term mortality (46 vs. 17%; hazard ratio 3.2; 95% confidence interval 2.1-4.7; P < 0.001). Among patients with AKI, 46/96 (48%) demonstrated recovery of renal function at hospital discharge. Lack of renal function recovery at discharge (50/96 patients; 52%) was associated with the occurrence of new or progression of baseline chronic kidney disease.CONCLUSION:
Among older patients with STEMI undergoing primary PCI, AKI is a frequent complication associated with adverse renal short-term and long-term outcomes.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Insuffisance rénale chronique
/
Atteinte rénale aigüe
/
Intervention coronarienne percutanée
/
Infarctus du myocarde avec sus-décalage du segment ST
Type d'étude:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Aged
/
Aged80
/
Humans
/
Male
Pays/Région comme sujet:
Asia
Langue:
En
Journal:
Coron Artery Dis
Sujet du journal:
ANGIOLOGIA
/
CARDIOLOGIA
Année:
2019
Type de document:
Article
Pays d'affiliation:
Israël