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High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study.
Cosentino, Nicola; Genovese, Stefano; Campodonico, Jeness; Bonomi, Alice; Lucci, Claudia; Milazzo, Valentina; Moltrasio, Marco; Biondi, Maria Luisa; Riggio, Daniela; Veglia, Fabrizio; Ceriani, Roberto; Celentano, Katia; De Metrio, Monica; Rubino, Mara; Bartorelli, Antonio L; Marenzi, Giancarlo.
Affiliation
  • Cosentino N; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Genovese S; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Campodonico J; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Bonomi A; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Lucci C; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Milazzo V; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Moltrasio M; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Biondi ML; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Riggio D; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Veglia F; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Ceriani R; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Celentano K; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • De Metrio M; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Rubino M; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Bartorelli AL; Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
  • Marenzi G; Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, 20138 Milan, Italy.
J Clin Med ; 8(12)2019 Dec 12.
Article in En | MEDLINE | ID: mdl-31842300
Background. Accumulating evidence suggests that inflammation plays a key role in acute kidney injury (AKI) pathogenesis. We explored the relationship between high-sensitivity C-reactive protein (hs-CRP) and AKI in acute myocardial infarction (AMI). Methods. We prospectively included 2,063 AMI patients in whom hs-CRP was measured at admission. AKI incidence and a clinical composite of in-hospital death, cardiogenic shock, and acute pulmonary edema were the study endpoints. Results. Two-hundred-thirty-four (11%) patients developed AKI. hs-CRP levels were higher in AKI patients (45 ± 87 vs. 16 ± 41 mg/L; p < 0.0001). The incidence and severity of AKI, as well as the rate of the composite endpoint, increased in parallel with hs-CRP quartiles (p for trend <0.0001 for all comparisons). A significant correlation was found between hs-CRP and the maximal increase of serum creatinine (R = 0.23; p < 0.0001). The AUC of hs-CRP for AKI prediction was 0.69 (p < 0.001). At reclassification analysis, addition of hs-CRP allowed to properly reclassify 14% of patients when added to creatinine and 8% of patients when added to a clinical model. Conclusions. In AMI, admission hs-CRP is closely associated with AKI development and severity, and with in-hospital outcomes. Future research should focus on whether prophylactic renal strategies in patients with high hs-CRP might prevent AKI and improve outcome.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: J Clin Med Year: 2019 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: J Clin Med Year: 2019 Document type: Article Affiliation country: Country of publication: