Acute kidney injury in ST-segment elevation acute myocardial infarction complicated by cardiogenic shock at admission

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Abstract

Objective: To evaluate the clinical and prognostic relevance of acute kidney injury (AKI) in the setting of ST-elevation acute myocardial infarction (STEMI) complicated by cardiogenic shock (CS). Design: Prospective study. Setting: Single-center study, 13-bed intensive cardiac care unit at a University Cardiological Center. Patients: Ninety-seven consecutive STEMI patients with CS at admission, undergoing intra-aortic balloon pump (IABP) support and primary percutaneous coronary intervention (PCI). Interventions: None. Measurements and Main Results: We measured serum creatinine at baseline and each day for the following 3 days. Acute kidney injury was defined as a rise in creatinine >25% from baseline.Overall, AKI occurred in 52 (55%) patients, and in 12 of these patients, a renal replacement therapy was required. In multivariate analysis, age >75 yrs (p =.005), left ventricular ejection fraction ≤40% (p =.009), and use of mechanical ventilation (p =.01) were independent predictors of AKI. Patients developing AKI had a longer hospital stay, a more complicated clinical course, and significantly higher mortality rate (50% vs. 2.2%; p

Original languageEnglish
Pages (from-to)438-444
Number of pages7
JournalCritical Care Medicine
Volume38
Issue number2
DOIs
Publication statusPublished - Feb 2010

Keywords

  • Acute kidney injury
  • Cardiogenic shock
  • Intra-aortic balloon pump
  • Primary percutaneous coronary intervention
  • ST-elevation acute myocardial infarction

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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