Open AccessProlonged Hyperglycemia and Renal Failure after Primary Percutaneous Coronary Intervention
Author(s) -
Elena Izkhakov,
Zach Rozenbaum,
Gilad Margolis,
Shafik Khoury,
Gad Keren,
Yacov Shacham
Publication year - 2019
Publication title -
cardiorenal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.661
H-Index - 21
eISSN - 1664-3828
pISSN - 1664-5502
DOI - 10.1159/000495704
Subject(s) - medicine , percutaneous coronary intervention , myocardial infarction , conventional pci , acute kidney injury , kidney disease , cardiology , renal function , diabetes mellitus , incidence (geometry) , gastroenterology , endocrinology , physics , optics
Background: There are limited data regarding the effect of long-standing hyperglycemia on the occurrence of acute kidney injury (AKI) in ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). Methods: We retrospectively studied 723 STEMI patients undergoing primary PCI. Patients were stratified into two groups according to glycated hemoglobin (HbA1c) levels as a marker of prolonged hyperglycemia: those with HbA1c < 7% and those with HbA1c ≥7%. Medical records were reviewed for the occurrence of AKI. Results: HbA1c levels ≥7% were found in 225/723 (31%) of patients. The occurrence of AKI was significantly higher among patients with HbA1c levels ≥7% (32/225, 14%) compared to patients with HbA1c levels < 7% (32/498, 6%; p = 0.001). Patients with chronic kidney disease (CKD) and HbA1c ≥7% had an eight-fold increase in the incidence of AKI compared to patients with HbA1c < 7% and no CKD (32 vs. 4%). In a multivariable regression model, HbA1c ≥7% was independently associated with AKI (OR 1.92, 95% CI 1.09–3.36, p = 0.02). Conclusion: HbA1c ≥7% was associated with a higher likelihood of AKI in STEMI patients treated with primary PCI.