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Medicine (Baltimore) ; 102(42): e35482, 2023 Oct 20.
Article in English | MEDLINE | ID: mdl-37861475

ABSTRACT

Acute kidney injury (AKI) is a sudden decline in renal function after cardiac surgery. It is characterized by a significant reduction in glomerular filtration rate, alterations in serum creatinine (S.Cr) levels, and urine output. This study aimed to retrospectively analyze a cohort of 704 patients selected using stringent inclusion and exclusion criteria. AKI was defined by an increase of 0.3 mg/dL in S.Cr levels compared to baseline. Data were collected from the hospital and analyzed using SPSS 16.0. Data analysis revealed that 22% (n = 155) of the patients developed AKI on the second post-operative day, accompanied by a substantial increase in S.Cr levels (from 1.064 ±â€…0.2504 to 1.255 ±â€…0.2673, P < .000). Age and cardiopulmonary bypass duration were identified as risk factors along with ejection fraction and days of hospital stay, contributing to the development of AKI. Early renal replacement therapy can be planned when the diagnosis of AKI is established early after surgery.


Subject(s)
Acute Kidney Injury , Coronary Artery Bypass , Humans , Retrospective Studies , Tertiary Care Centers , Pakistan/epidemiology , Prevalence , Coronary Artery Bypass/adverse effects , Risk Factors , Acute Kidney Injury/diagnosis , Acute Kidney Injury/epidemiology , Acute Kidney Injury/etiology , Kidney/physiology , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Creatinine , Cardiopulmonary Bypass/adverse effects
2.
Am J Cardiol ; 195: 9-16, 2023 05 15.
Article in English | MEDLINE | ID: mdl-36989606

ABSTRACT

Currently, guidelines recommend the uptake of high-dose statins before and after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome. However, the association of high-dose statins with the incidence of the no-reflow phenomenon remains unclear. This study aimed to review the evidence of preprocedural high-dose statin therapy to reduce no-reflow incidence after PCI. PubMed, Embase, and Google Scholar were searched from inception until May 2022 for studies comparing high-dose statins with low-dose or no statin therapy before PCI. Studies reporting the no-reflow phenomenon were shortlisted. The National Institutes of Health tool for randomized and cohort studies was used to assess the quality of included studies. A random-effects model was used to derive odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). A total of 11 studies were included, with a population of 4,294 patients. The use of high-dose statins before PCI significantly reduced postprocedural no-reflow (OR 0.51, 95% CI 0.35 to 0.74, p = 0.0005, I2 = 32%). A total of 7 studies included patients who underwent PCI without previous use of statins. A significant decrease in overall no-reflow events was observed with high-intensity statin treatment versus low-intensity statin/placebo (OR 0.55, 95% CI 0.34 to 0.88, p = 0.01, I2 = 25%) among patients who were statin naive. Acute high-dose statin therapy before PCI significantly reduces the hazard of post-PCI no-reflow events in patients with acute coronary syndrome. Our results encourage the routine use of statins before PCI.


Subject(s)
Acute Coronary Syndrome , Hydroxymethylglutaryl-CoA Reductase Inhibitors , No-Reflow Phenomenon , Percutaneous Coronary Intervention , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Acute Coronary Syndrome/drug therapy , Acute Coronary Syndrome/surgery , Percutaneous Coronary Intervention/adverse effects , No-Reflow Phenomenon/etiology , No-Reflow Phenomenon/prevention & control , Cohort Studies
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