Abstract 13256: Impact of Albuminuria on Contrast-induced Acute Kidney Injury and In-hospital Adverse Cardiac Events in Patients Who Underwent Emergency Coronary Intervention
Purpose: The aim of this study was to evaluate the predictive value of albuminuria for risk of contrast-induced acute kidney injury (CI-AKI) and in-hospital adverse events (AE) in patients with ACS who underwent emergency PCI.
Methods: A total of 215 consecutive ACS patients undergoing emergency PCI were enrolled. Urinary albumin to creatinin ratio (ACR; mg/gCr) was measured and patients were divided into three groups as follows; normoalbuminuria (ACR <30 mg/gCr, 126 patients), microalbuminuria (30≤ ACR <300mg/gCr, 72 patients) and macroalbuminuria (300≤ ACR mg/gCR, 17 patients).CI-AKI was defined as a greater than 25% increase in creatinine from the baseline or an absolute increase of ≥0.5mg/dl within 72h after the procedure. In-hospital AE was defined as the composite of cardiovascular death, pulmonary edema, unplanned PCI or CABG, fatal arrhythmias.
Results: Incidence of CI-AKI (p<0.0001) and in-hospital AE (p=0.001) were gradually increased among three groups.Length of stay in ICU was significantly longer in macroalbuminuria group than the other group (p=0.008). Multivariate logistic regression analysis, adjusting for potential confounding factors, resulted in an odds ratio(OR) for CI-AKI in macroalbuminuria group was 6.58 (95%CI, 1.364-31.736; p=0.019) and 3.96 (95%CI 1.457-10.774, p=0.007) in microalbuminuria group when compared with normoalbuminuria group. OR for in-hospital AE in macroalbuminuria group was 5.80 (95%CI 1.347-24.936; p=0.018) and 3.59 in microalbuminuria group (95%CI 1.674-7.697, p=0.001) when compared with normoalbuminuria group.
Conclusions: The elevated urinary albumin excretion rate is an independent predictor of CI-AKI and in-hospital AE in patients with ACS and graded increase in the incidence across microalbuminuria to macroalbuminuria were observed.
Author Disclosures: A. Kunimura: None. T. Uetani: None. T. Kataoka: None. M. Takeshita: None. K. Harada: None. S. Okumura: None. N. Shinoda: None. K. Harada: None. B. Kato: None. M. Kato: None. N. Marui: None. M. Nanki: None. T. Matsubara: None. H. Ishii: None. T. Amano: None. T. Murohara: None.
- © 2014 by American Heart Association, Inc.