Relationship between acute kidney injury after interventional therapy and short-term prognosis in patients with acute coronary syndrome / 医学研究生学报

ABSTRACT

ObjectivePercutaneous coronary intervention (PCI) may cause acute kidney injury (AKI) in some patients with acute coronary syndrome (ACS), leading to persistent renal dysfunction. This study aimed to investigate the relationship between acute kidney injury after PCI and short-term prognosis in patients with ACS.MethodsData of 333 patients with ACS who underwent PCI in our hospital were included. According to whether the serum creatinine level was increased above 25% during 1st to 3rd day after PCI than the preoperative, patients was divided into AKI group (n=38) and non-AKI group (n=295). Risk factors for AKI in patients with ACS after PCI were analyzed. Adverse cardiovascular events and survival rates between the two groups were compared. Univariate and multivariate analysis were performed to determine the risk factors on short-term survival after surgery.ResultsAge, diabetes, preoperative renal insufficiency, left ventricular ejection fraction (LVEF), contrast dose and count of lesion coronary artery were independent risk factors for AKI after PCI (P<0.05). Within 1 year after surgery, the total incidence of cardiovascular adverse events in the AKI group and the non-AKI group were 28.9% and 5.8%, respectively, and the difference was statistically significant(χ2=20.582, P=0.000). The patients were followed up for 2.9 to 17.2 months with a median follow up of 8.6 months. The 6-month cumulative survival rate of AKI group and non-AKI group were 94.1% and 99.6%, respectively. The 1 year cumulative survival rate was 84.2% and 96.1%, respectively. The difference in overall survival rate between the two groups was statistically significant(χ2=9.216, P=0.002). Short-term survival after PCI was associated with AKI(χ2=20.582, P=0.000), LVEF (χ2=9.055, P=0.003), count of lesion coronary artery (χ2=5.749, P=0.016) and preoperative Killip grading(χ2=4.823, P=0.028). AKI and LVEF were independent predictors of short-term survival after PCI (P<0.05).ConclusionAKI in patients with ACS after PCI has a poorer short-term prognosis, which can be used as an important factor in disease assessment and risk stratification.