Document Detail


Short-term outcomes of acute myocardial infarction in patients with acute kidney injury: a report from the national cardiovascular data registry.
MedLine Citation:
PMID:  22179533     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Acute kidney injury (AKI) is a risk factor for long-term adverse outcomes, including acute myocardial infarction and death. However, the relationship between severity of AKI and in-hospital outcomes in the setting of acute myocardial infarction has not been well documented.
METHODS AND RESULTS: The study population (n = 59,970) was drawn from the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry-Get With the Guidelines (GWTG), a nationwide sample of myocardial infarction patients admitted to 383 hospitals in the United States between July 2008 and September 2009. AKI was defined using absolute changes in serum creatinine (SCr; peak SCr minus admission SCr) and categorized as no AKI (SCr change, <0.3 mg/dL), mild AKI (SCr change, 0.3-<0.5 mg/dL), moderate AKI (SCr change, 0.5-<1.0 mg/dL), and severe AKI (SCr change, ≥1.0 mg/dL). Overall, 16.1% had AKI, including 6.5% with mild AKI, 5.6% with moderate AKI, and 4.0% with severe AKI. In-hospital mortality rates for those with mild, moderate, and severe AKI were 6.6%, 14.2%, and 31.8% compared with 2.1% in those without AKI. The odds ratios for in-hospital death were 2.4 (95% confidence interval, 2.0-2.7), 4.5 (95% confidence interval, 3.9-5.1), and 12.6 (95% confidence interval, 11.1-14.3) for mild, moderate, and severe AKI compared with those without AKI. Although patients with AKI were less likely to undergo early invasive care or to receive antiplatelet therapies, rates of major bleeding ranged from 8.4% (no AKI) to 32.7% (severe AKI).
CONCLUSION: AKI is common and associated with mortality and bleeding, underscoring the importance of efforts to identify risk factors and to prevent AKI in acute myocardial infarction care.
Authors:
Caroline S Fox; Paul Muntner; Anita Y Chen; Karen P Alexander; Matthew T Roe; Stephen D Wiviott
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Publication Detail:
Type:  Journal Article     Date:  2011-12-16
Journal Detail:
Title:  Circulation     Volume:  125     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-24     Completed Date:  2012-03-13     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  497-504     Citation Subset:  AIM; IM    
Affiliation:
NHLBI's Framingham Heart Study, Division of Intramural Research, NHLBI, 73 Mt Wayte Ave, Ste 2, Framingham, MA 01702, USA. foxca@nhlbi.nih.gov
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MeSH Terms
Descriptor/Qualifier:
Acute Kidney Injury / mortality*
Aged
Aged, 80 and over
Female
Hemorrhage / mortality
Hospital Mortality / trends*
Humans
Inpatients / statistics & numerical data
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / mortality*
Prevalence
Registries / statistics & numerical data*
Risk Factors
Severity of Illness Index
United States / epidemiology
Grant Support
ID/Acronym/Agency:
Z99 HL999999/HL/NHLBI NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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