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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...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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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. |
format | Online Article Text |
id | pubmed-6947188 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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