Article PDF first page preview

First page of Early Versus Late Acute Kidney Injury in Patients Undergoing Primary Percutaneous Coronary Intervention

Introduction: Acute kidney injury (AKI) frequently complicates ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) and is associated with increased short- and long-term mortality. However, the impact of the AKI onset time following PCI on patient outcomes remains uncertain. This study aimed to investigate the timing of post-PCI AKI development and its prognostic significance in STEMI patients. Methods: This retrospective cohort study included 2,912 STEMI patients who underwent successful PCI upon admission. The timing of AKI was determined according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria, using routine blood tests conducted during hospitalization. The primary endpoint was all-cause mortality. Results: Among 2,912 STEMI patients studied, 222 (7.6%) developed AKI. AKI was classified as early if it occurred within 1.5 days (n=108, 48.6%) or late if it occurred after 1.5 days (n=114, 51.4%). Early AKI was associated with a significantly higher incidence of cardiogenic shock at presentation, lower post-PCI left ventricular ejection fraction, and increased 30-day mortality compared to late AKI. In multivariate Cox regression analysis, early AKI emerged as an independent predictor of long-term mortality (adjusted HR 1.8, 95% CI 1.1-2.8, p=0.015). Additionally, multivariate logistic regression analysis identified cardiogenic shock as a significant predictor of early AKI (adjusted OR 2.3, 95% CI 1.1-4.9, p=0.03). Conclusion: In STEMI patients, early AKI—compared to late AKI—is associated with higher short- and long-term mortality and occurs more frequently in those presenting with cardiogenic shock.

The Author(s). Published by S. Karger AG, Basel
Open Access License / Drug Dosage / Disclaimer
This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2025
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License .
Attribution-NonCommercial