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Analysis of biomarkers for risk of acute kidney injury after primary angioplasty for acute st-segment elevation myocardial infarction: Results of the HORIZONS-AMI trial.
MedLine Citation:
PMID:  25130788     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives: Contrast-induced acute kidney injury (CI-AKI) may occur after percutaneous coronary intervention (PCI). We sought to evaluate patients with ST-elevation myocardial infarction (STEMI) undergoing emergency PCI and evaluated their risk for CI-AKI. Methods: Serum biomarkers were measured in patients who provided specific written informed consent for blood withdrawal at baseline, discharge, and 30-day and 1-year follow-up. Results: Of the 390 patients enrolled in the HORIZONS-AMI biomarker substudy, 56 (14.3%) developed AKI. In the AKI group, the levels of B-type natriuretic peptide (BNP) were consistently higher than in the no-AKI group at baseline (p=0.0327), hospital discharge (p=0.0002), 30-day follow-up (p=0.0193), and 1-year follow-up (p=0.031). At hospital discharge the AKI group had elevated biomarkers compared to the no-AKI group: D-dimer (p= 0.0066), C-reactive protein (p=0.0468), endothelial cell-selective adhesion molecule (p=0.0169), adiponectin (p=0.0346), and von Willebrand factor (p=0.0168); there was also a trend towards higher cystatin C (p=0.0585) in the AKI group. Similar correlations between biomarker panel increase and the development of CI-AKI were consistent at baseline, 30-day, and 1-year follow-up. Chemokine (C-C motif) ligand 23 showed an opposite pattern with an increase at all time points in the no-AKI compared to the AKI group. Conclusions: The risk of CI-AKI after primary PCI for STEMI may be associated with hemostatic imbalances, activation of procoagulants, decreased endogenous anticoagulants, enhanced inflammation, platelet activation, or decreased fibrinolytic activity. © 2014 Wiley Periodicals, Inc.
Authors:
Alejandra Guerchicoff; Gregg W Stone; Roxana Mehran; Ke Xu; Dru Nichols; Bimmer E Claessen; Giulio Guagliumi; Bernhard Witzenbichler; José P S Henriques; George D Dangas
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-30
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-8-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Wiley Periodicals, Inc., a Wiley company.
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