Abstract 13892: Early as Compared to Late Development of Acute Kidney Injury is a Strong Predictor of In-Hospital Mortality in Patients With Acute Myocardial Infarction
Background: Acute kidney injury (AKI) often occurs in patients with acute myocardial infarction (AMI) and is associated with unfavorable outcomes. However, the impact of timing of AKI development on prognosis after AMI remains unclear.
Method: This study consisted of 760 patients with AMI who admitted to the National Cerebral and Cardiovascular Center of Japan within 48 hours after symptom onset. Blood sample was obtained on admission and repeated every day for the first 3 days, and then at least every one or two days during the first week. AKI was diagnosed by AKI network criteria: increase in serum creatinine level ≥0.3mg/dl or ≥50% within 48 hours. Patients were divided into 2 groups according to the timing of AKI development: early AKI (within 48 hours after admission) and late AKI (>48 hours).
Results: AKI developed in 95 patients (13%), who had higher in-hospital mortality than those without AKI (25.3% vs 3.0%, p<0.001). There were 63 patients with early AKI (66.3%), and 32 patients with late AKI (33.7%). Patients with early AKI had higher in-hospital mortality than those with late AKI (34.9% vs 6.3%, p=0.002). Recovery from early AKI was observed in 69.8% of the patients. The morality of patients with recovery from early AKI had lower mortality than those without recovery from early AKI (18.1% vs 73.7%, p<0.001). Mortality of patients with recovery of early AKI was significantly higher than those without AKI (p<0.001) and tended to be higher than those with late AKI (p=0.13).
Conclusion: These findings suggested that early AKI was associated with higher in-hospital mortality after AMI as compared to late AKI. Patients with persistent renal dysfunction after early AKI had the worst outcome, but patients with early AKI were at high risk of mortality even if renal function was once returned to baseline level.
- © 2013 by American Heart Association, Inc.