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High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study

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 patien...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947188/
https://www.ncbi.nlm.nih.gov/pubmed/31842300
http://dx.doi.org/10.3390/jcm8122192
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author 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
author_facet 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
author_sort Cosentino, Nicola
collection PubMed
description 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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spelling pubmed-69471882020-01-13 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 J Clin Med Article 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. MDPI 2019-12-12 /pmc/articles/PMC6947188/ /pubmed/31842300 http://dx.doi.org/10.3390/jcm8122192 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
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
High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study
title High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study
title_full High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study
title_fullStr High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study
title_full_unstemmed High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study
title_short High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study
title_sort high-sensitivity c-reactive protein and acute kidney injury in patients with acute myocardial infarction: a prospective observational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947188/
https://www.ncbi.nlm.nih.gov/pubmed/31842300
http://dx.doi.org/10.3390/jcm8122192
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