Renal function, acute kidney injury and hospital mortality in patients with acute myocardial infarction

Abstract

Objectives: To examine retrospectively the relationship between acute kidney injury (AKI) and acute myocardial infarction (AMI), and the association between estimated glomerular filtration rate (eGFR) at admission and AKI outcome.

Methods: AKI was defined as an increase in serum creatinine (SCr) by ≥ 0.3 mg/dl within 48 h or an increase in SCr to ≥ 1.5 times baseline within the first 7 days of hospitalization. Patients with AMI were divided into subgroups according to their eGFR at admission and the development of AKI.

Results: This study enrolled 396 patients with AMI; 48 (12.1%) developed AKI. In-hospital mortality was 39.6% (19/48) for patients with AKI compared with 7.5% (26/348) in those without AKI (odds ratio [OR] 8.11; 95% confidence interval [CI] 4.02, 16.39). The mortality rate was 35.7% (five of 14) in the eGFR ≥ 60 ml/min/1.73 m(2) with AKI group (OR 6.21, 95% CI 1.50, 25.69) and 41.2% (14/34) in the eGFR <60 ml/min/1.73 m(2) with AKI group (OR 12.62, 95% CI 5.54, 28.74).

Conclusions: AKI development was common and associated with mortality in AMI patients with either preserved or impaired eGFR levels.

Keywords: Acute kidney injury; acute myocardial infarction; glomerular filtration rate; mortality; renal function.