Impact of acute kidney injury on in-hospital outcomes of patients with acute myocardial infarction

Results from the japanese registry of acute myocardial infarction diagnosed by Universal Definition (J-MINUET) substudy

on behalf of J-MINUET Investigators

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Acute kidney injury (AKI) is associated with poor outcome after acute myocardial infarction (AMI), but whether hemodynamic status at presentation influences this prognostic significance is unknown. Methods and Results: A total of 2,798 AMI patients admitted within 48 h after symptom onset and who underwent urgent coronary angiography were enrolled in the present study. AKI was defined as an increase in serum creatinine ≥0.3 mg/dL or ≥50% within 48 h during hospitalization. Patients were classified into 3 groups according to Killip class on admission: Killip 1, n=2,164; Killip 2–3, n=366; and Killip 4, n=268. AKI occurred more frequently with increasing Killip class (Killip 1, 2–3, and 4: 6.3%, 15.3%, and 31.3%, respectively; P<0.001). AKI was associated with increased in-hospital mortality, regardless of Killip class (non-AKI and AKI patients: 1.1% vs. 6.6% in Killip 1; 5.2% vs. 35.7% in Killip 2–3, and 28.8% vs. 45.2% in Killip 4, P<0.01 for all). On multivariate analysis, the adjusted OR of AKI for in-hospital mortality in Killip 1, Killip 2–3, and Killip 4 were 3.79 (95% CI: 1.54–9.33, P=0.004), 5.35 (95% CI: 2.67–10.7, P<0.001), and 1.48 (95% CI: 0.94–2.35, P=0.093), respectively. Conclusions: In AMI patients undergoing urgent coronary angiography, AKI was significantly associated with increased in-hospital mortality in Killip 1 as well as Killip 2–3 at presentation, but not in Killip 4.

Original languageEnglish
Pages (from-to)733-739
Number of pages7
JournalCirculation Journal
Volume81
Issue number5
DOIs
Publication statusPublished - 01-01-2017

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Acute Kidney Injury
Registries
Myocardial Infarction
Hospital Mortality
Coronary Angiography
Creatinine
Hospitalization
Multivariate Analysis
Hemodynamics
Kidney
Serum

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{aa820904578a4985a6783c364518311f,
title = "Impact of acute kidney injury on in-hospital outcomes of patients with acute myocardial infarction: Results from the japanese registry of acute myocardial infarction diagnosed by Universal Definition (J-MINUET) substudy",
abstract = "Background: Acute kidney injury (AKI) is associated with poor outcome after acute myocardial infarction (AMI), but whether hemodynamic status at presentation influences this prognostic significance is unknown. Methods and Results: A total of 2,798 AMI patients admitted within 48 h after symptom onset and who underwent urgent coronary angiography were enrolled in the present study. AKI was defined as an increase in serum creatinine ≥0.3 mg/dL or ≥50{\%} within 48 h during hospitalization. Patients were classified into 3 groups according to Killip class on admission: Killip 1, n=2,164; Killip 2–3, n=366; and Killip 4, n=268. AKI occurred more frequently with increasing Killip class (Killip 1, 2–3, and 4: 6.3{\%}, 15.3{\%}, and 31.3{\%}, respectively; P<0.001). AKI was associated with increased in-hospital mortality, regardless of Killip class (non-AKI and AKI patients: 1.1{\%} vs. 6.6{\%} in Killip 1; 5.2{\%} vs. 35.7{\%} in Killip 2–3, and 28.8{\%} vs. 45.2{\%} in Killip 4, P<0.01 for all). On multivariate analysis, the adjusted OR of AKI for in-hospital mortality in Killip 1, Killip 2–3, and Killip 4 were 3.79 (95{\%} CI: 1.54–9.33, P=0.004), 5.35 (95{\%} CI: 2.67–10.7, P<0.001), and 1.48 (95{\%} CI: 0.94–2.35, P=0.093), respectively. Conclusions: In AMI patients undergoing urgent coronary angiography, AKI was significantly associated with increased in-hospital mortality in Killip 1 as well as Killip 2–3 at presentation, but not in Killip 4.",
author = "{on behalf of J-MINUET Investigators} and Shotaro Kuji and Masami Kosuge and Kazuo Kimura and Koichi Nakao and Yukio Ozaki and Junya Ako and Teruo Noguchi and Satoshi Yasuda and Satoru Suwa and Kazuteru Fujimoto and Yasuharu Nakama and Takashi Morita and Wataru Shimizu and Yoshihiko Saito and Atsushi Hirohata and Yasuhiro Morita and Teruo Inoue and Kunihiro Nishimura and Yoshihiro Miyamoto and Masaharu Ishihara",
year = "2017",
month = "1",
day = "1",
doi = "10.1253/circj.CJ-16-1094",
language = "English",
volume = "81",
pages = "733--739",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "5",

}

TY - JOUR

T1 - Impact of acute kidney injury on in-hospital outcomes of patients with acute myocardial infarction

T2 - Results from the japanese registry of acute myocardial infarction diagnosed by Universal Definition (J-MINUET) substudy

AU - on behalf of J-MINUET Investigators

AU - Kuji, Shotaro

AU - Kosuge, Masami

AU - Kimura, Kazuo

AU - Nakao, Koichi

AU - Ozaki, Yukio

AU - Ako, Junya

AU - Noguchi, Teruo

AU - Yasuda, Satoshi

AU - Suwa, Satoru

AU - Fujimoto, Kazuteru

AU - Nakama, Yasuharu

AU - Morita, Takashi

AU - Shimizu, Wataru

AU - Saito, Yoshihiko

AU - Hirohata, Atsushi

AU - Morita, Yasuhiro

AU - Inoue, Teruo

AU - Nishimura, Kunihiro

AU - Miyamoto, Yoshihiro

AU - Ishihara, Masaharu

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: Acute kidney injury (AKI) is associated with poor outcome after acute myocardial infarction (AMI), but whether hemodynamic status at presentation influences this prognostic significance is unknown. Methods and Results: A total of 2,798 AMI patients admitted within 48 h after symptom onset and who underwent urgent coronary angiography were enrolled in the present study. AKI was defined as an increase in serum creatinine ≥0.3 mg/dL or ≥50% within 48 h during hospitalization. Patients were classified into 3 groups according to Killip class on admission: Killip 1, n=2,164; Killip 2–3, n=366; and Killip 4, n=268. AKI occurred more frequently with increasing Killip class (Killip 1, 2–3, and 4: 6.3%, 15.3%, and 31.3%, respectively; P<0.001). AKI was associated with increased in-hospital mortality, regardless of Killip class (non-AKI and AKI patients: 1.1% vs. 6.6% in Killip 1; 5.2% vs. 35.7% in Killip 2–3, and 28.8% vs. 45.2% in Killip 4, P<0.01 for all). On multivariate analysis, the adjusted OR of AKI for in-hospital mortality in Killip 1, Killip 2–3, and Killip 4 were 3.79 (95% CI: 1.54–9.33, P=0.004), 5.35 (95% CI: 2.67–10.7, P<0.001), and 1.48 (95% CI: 0.94–2.35, P=0.093), respectively. Conclusions: In AMI patients undergoing urgent coronary angiography, AKI was significantly associated with increased in-hospital mortality in Killip 1 as well as Killip 2–3 at presentation, but not in Killip 4.

AB - Background: Acute kidney injury (AKI) is associated with poor outcome after acute myocardial infarction (AMI), but whether hemodynamic status at presentation influences this prognostic significance is unknown. Methods and Results: A total of 2,798 AMI patients admitted within 48 h after symptom onset and who underwent urgent coronary angiography were enrolled in the present study. AKI was defined as an increase in serum creatinine ≥0.3 mg/dL or ≥50% within 48 h during hospitalization. Patients were classified into 3 groups according to Killip class on admission: Killip 1, n=2,164; Killip 2–3, n=366; and Killip 4, n=268. AKI occurred more frequently with increasing Killip class (Killip 1, 2–3, and 4: 6.3%, 15.3%, and 31.3%, respectively; P<0.001). AKI was associated with increased in-hospital mortality, regardless of Killip class (non-AKI and AKI patients: 1.1% vs. 6.6% in Killip 1; 5.2% vs. 35.7% in Killip 2–3, and 28.8% vs. 45.2% in Killip 4, P<0.01 for all). On multivariate analysis, the adjusted OR of AKI for in-hospital mortality in Killip 1, Killip 2–3, and Killip 4 were 3.79 (95% CI: 1.54–9.33, P=0.004), 5.35 (95% CI: 2.67–10.7, P<0.001), and 1.48 (95% CI: 0.94–2.35, P=0.093), respectively. Conclusions: In AMI patients undergoing urgent coronary angiography, AKI was significantly associated with increased in-hospital mortality in Killip 1 as well as Killip 2–3 at presentation, but not in Killip 4.

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U2 - 10.1253/circj.CJ-16-1094

DO - 10.1253/circj.CJ-16-1094

M3 - Article

VL - 81

SP - 733

EP - 739

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 5

ER -