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Clinical Scoring for Prediction of Acute Kidney Injury in Patients with Acute ST-Segment Elevation Myocardial Infarction after Emergency Primary Percutaneous Coronary Intervention

Acute kidney injury (AKI) after a coronary intervention is common in patients with ST-segment elevation myocardial infarction (STEMI) and is associated with significant morbidity and mortality. Several scores have been developed to predict post-procedural AKI over the years. However, the AKI definit...

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Autores principales: Kaladee, Akaphol, Phinyo, Phichayut, Chantadansuwan, Thamarath, Patumanond, Jayanton, Siribumrungwong, Boonying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8348987/
https://www.ncbi.nlm.nih.gov/pubmed/34362182
http://dx.doi.org/10.3390/jcm10153402
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author Kaladee, Akaphol
Phinyo, Phichayut
Chantadansuwan, Thamarath
Patumanond, Jayanton
Siribumrungwong, Boonying
author_facet Kaladee, Akaphol
Phinyo, Phichayut
Chantadansuwan, Thamarath
Patumanond, Jayanton
Siribumrungwong, Boonying
author_sort Kaladee, Akaphol
collection PubMed
description Acute kidney injury (AKI) after a coronary intervention is common in patients with ST-segment elevation myocardial infarction (STEMI) and is associated with significant morbidity and mortality. Several scores have been developed to predict post-procedural AKI over the years. However, the AKI definitions have also evolved, which causes the definitions used in the past to be obsolete. We aimed to develop a prediction score for AKI in patients with STEMI requiring emergency primary percutaneous coronary intervention (pPCI). This study was based on a retrospective cohort of Thai patients with STEMI who underwent pPCI at the Central Chest Institute of Thailand from December 2014 to September 2019. AKI was defined as an increase in serum creatinine of at least 0.3 mg/dL from baseline within 48 h after pPCI. Logistic regression was used for modeling. A total of 1617 patients were included. Of these, 195 patients had AKI (12.1%). Eight significant predictors were identified: age, baseline creatinine, left ventricular ejection fraction (LVEF) < 40%, multi-vessel pPCI, treated with thrombus aspiration, inserted intra-aortic balloon pump (IABP), pre- and intra-procedural cardiogenic shock, and congestive heart failure. The score showed an area under the receiver operating characteristic curve of 0.78 (95% CI 0.75, 0.82) and was well-calibrated. The pPCI-AKI score showed an acceptable predictive performance and was potentially useful to help interventionists stratify the patients and provide optimal preventive management.
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spelling pubmed-83489872021-08-08 Clinical Scoring for Prediction of Acute Kidney Injury in Patients with Acute ST-Segment Elevation Myocardial Infarction after Emergency Primary Percutaneous Coronary Intervention Kaladee, Akaphol Phinyo, Phichayut Chantadansuwan, Thamarath Patumanond, Jayanton Siribumrungwong, Boonying J Clin Med Article Acute kidney injury (AKI) after a coronary intervention is common in patients with ST-segment elevation myocardial infarction (STEMI) and is associated with significant morbidity and mortality. Several scores have been developed to predict post-procedural AKI over the years. However, the AKI definitions have also evolved, which causes the definitions used in the past to be obsolete. We aimed to develop a prediction score for AKI in patients with STEMI requiring emergency primary percutaneous coronary intervention (pPCI). This study was based on a retrospective cohort of Thai patients with STEMI who underwent pPCI at the Central Chest Institute of Thailand from December 2014 to September 2019. AKI was defined as an increase in serum creatinine of at least 0.3 mg/dL from baseline within 48 h after pPCI. Logistic regression was used for modeling. A total of 1617 patients were included. Of these, 195 patients had AKI (12.1%). Eight significant predictors were identified: age, baseline creatinine, left ventricular ejection fraction (LVEF) < 40%, multi-vessel pPCI, treated with thrombus aspiration, inserted intra-aortic balloon pump (IABP), pre- and intra-procedural cardiogenic shock, and congestive heart failure. The score showed an area under the receiver operating characteristic curve of 0.78 (95% CI 0.75, 0.82) and was well-calibrated. The pPCI-AKI score showed an acceptable predictive performance and was potentially useful to help interventionists stratify the patients and provide optimal preventive management. MDPI 2021-07-30 /pmc/articles/PMC8348987/ /pubmed/34362182 http://dx.doi.org/10.3390/jcm10153402 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kaladee, Akaphol
Phinyo, Phichayut
Chantadansuwan, Thamarath
Patumanond, Jayanton
Siribumrungwong, Boonying
Clinical Scoring for Prediction of Acute Kidney Injury in Patients with Acute ST-Segment Elevation Myocardial Infarction after Emergency Primary Percutaneous Coronary Intervention
title Clinical Scoring for Prediction of Acute Kidney Injury in Patients with Acute ST-Segment Elevation Myocardial Infarction after Emergency Primary Percutaneous Coronary Intervention
title_full Clinical Scoring for Prediction of Acute Kidney Injury in Patients with Acute ST-Segment Elevation Myocardial Infarction after Emergency Primary Percutaneous Coronary Intervention
title_fullStr Clinical Scoring for Prediction of Acute Kidney Injury in Patients with Acute ST-Segment Elevation Myocardial Infarction after Emergency Primary Percutaneous Coronary Intervention
title_full_unstemmed Clinical Scoring for Prediction of Acute Kidney Injury in Patients with Acute ST-Segment Elevation Myocardial Infarction after Emergency Primary Percutaneous Coronary Intervention
title_short Clinical Scoring for Prediction of Acute Kidney Injury in Patients with Acute ST-Segment Elevation Myocardial Infarction after Emergency Primary Percutaneous Coronary Intervention
title_sort clinical scoring for prediction of acute kidney injury in patients with acute st-segment elevation myocardial infarction after emergency primary percutaneous coronary intervention
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8348987/
https://www.ncbi.nlm.nih.gov/pubmed/34362182
http://dx.doi.org/10.3390/jcm10153402
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