Abstract 18870: Hyperglycaemia as a Predictor of Contrast-Induced Acute Kidney Injury in ST Elevation Myocardial Infarction Patients Treated With Primary Percutaneous Coronary Intervention
Introduction: Among patients with ST elevation myocardial (STEMI) the presence of hyperglycaemia is associated with a higher incidence of complications, including contrast-induced acute kidney injury (CI-AKI) and a higher mortality. However, limited data are present regarding the role of hyperglycaemia in predicting CI-AKI.
Hypothesis: This study investigated the association between hyperglycaemia both at hospital admission and the subsequent morning day after (AdmHyperg and FastHyperg) and the development of CI-AKI regardless of the presence of diabetes, in STEMI patients treated with primary PCI.
Methods: We prospectively enrolled all consecutive STEMI patients undergoing primary percutaneous coronary intervention (pPCI) in our Department in 2005-2014 (n = 2001). AdmHyperg and FastHyperg were defined, accordingly to literature, as plasma glucose values >198 mg/dL (or >11 mmol/L). CI-AKI was defined as an increase in creatinine values >0.5 mg/dl in the first 72 hours. Logistic regression models were performed to evaluate AdmHyperg and FastHyperg and the other potential predictors of CI-AKI.
Results: AdmHyperg and FastHyperg were present in 16.1% and 6.9% of the patients, respectively. CI-AKI occurred in 9.1% and 4.3% of patients with or without AdmHyperg, and 17% and 4% of patients with or without FastHyperg (all p<0.001), respectively. Multivariable analysis demonstrated that both AdmHyperg (OR 1.96, 95%CI 1.13-3.83, p=0.016) and FastHyperg (OR 5.43, 95%CI 2.88-10.23, p<0.001) were independent predictors of CI-AKI. Additional independent predictors of CI-AKI in both models were age, anterior MI, prior AMI, baseline haemoglobin and creatinine. Diabetes was not an independent predictor of CI-AKI when hyperglycaemia was included in the models.
Conclusions: Both admission hyperglycaemia and fasting hyperglycaemia were independent predictors of contrast-induced acute kidney injury in patients with STEMI undergoing primary PCI. The data suggest that the presence of long-lasting hyperglycaemia during hospitalization, more than a history of diabetes contributes to acute kidney injury.
Author Disclosures: S. Cornara: None. A. Somaschini: None. R. Camporotondo: None. M. Gnecchi: None. G. Crimi: None. A. Baldo: None. B. Marinoni: None. L. Oltrona Visconti: None. S. De Servi: None. G.M. De Ferrari: None.
- © 2016 by American Heart Association, Inc.