Evidence map›Paper›PMID 39251455›Full record

ArticleThe Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology2024

A study of the predictive role of multiple variables for the incidence of acute kidney injury and its outcomes in Indian patients with ST-elevation myocardial infarction and cardiogenic shock.

Kewal Kanabar, Yash Paul Sharma, Darshan Krishnappa, Krishna Santosh, Miren Dhudasia

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Article in The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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2 citing papers in PubMed.

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5 · Who and what money

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5 authors.

Kewal KanabarDepartment of Cardiology, U.N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, 380016, India. kewal.kanabar14@gmail.com.ORCID http://orcid.org/0000-0002-8228-7740
Yash Paul SharmaDepartment of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Darshan KrishnappaDepartment of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
Krishna SantoshDepartment of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Miren DhudasiaDepartment of Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute kidney injury (AKI) occurs frequently in ST-elevation myocardial infarction with cardiogenic shock (CS-STEMI) and is a strong independent prognostic marker for short and intermediate-term outcomes. Owing to the delayed presentation and limited facilities for primary percutaneous coronary intervention in low- and middle-income countries, the incidence, predictors, and outcome of AKI are likely to be different compared to the developed countries. We performed a post hoc analysis of patients presenting with CS-STEMI over 7 years (2016-2022) at a tertiary referral center in North India. The primary outcome assessed was AKI and the secondary outcome was in-hospital mortality.

resultsOf the 426 patients, 194 (45.5%) patients developed AKI, as defined by the Kidney Disease Improving Global Outcomes criteria. Left ventricular (LV) pump failure with pulmonary edema [Odds ratio (OR) 1.67; 95% confidence interval (CI) 1.04-2.67], LV ejection fraction (OR 1.35 per 10% decrease in ejection fraction; CI 1.04-1.73), complete heart block (OR 2.06; CI 1.2-3.53), right ventricular infarction (OR 2.76; CI 1.39-5.49), mechanical complications (OR 3.89; CI 1.85-8.21), ventricular tachycardia (OR 2.80; CI 1.57-4.99), and non-revascularization (OR 2.2; CI 1.33-3.67) were independent predictors of AKI in multivariate logistic regression analysis. Additionally, AKI was a strong predictor of in-hospital mortality (univariate OR 30.61, CI 17.37-53.95).

conclusionsThere is a higher incidence of AKI in CS-STEMI in resource-limited settings and is associated with adverse short-term outcomes. Additional studies are needed to address the optimal strategies for the prevention and management of AKI in such settings.

Indexed as

AKICardiogenic shockMortalityST-elevation myocardial infarction

Identifiers

PMID39251455
PMCPMC11384670

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