High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study
Abstract
:1. Introduction
2. Material and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variable | Acute Kidney Injury | ||
---|---|---|---|
No | Yes | p Value | |
(n = 1829) | (n = 234) | ||
Age (years) | 66 ± 12 | 74 ± 11 | <0.0001 |
Male sex, n (%) | 1351 (74%) | 165 (71%) | 0.27 |
Body weight (kg) | 76 ± 14 | 76 ± 16 | 0.88 |
Diabetes mellitus, n (%) | 386 (21%) | 87 (37%) | <0.0001 |
Hypertension, n (%) | 1157 (63%) | 178 (76%) | 0.0001 |
Smokers, n (%) | 1003 (55%) | 95 (41%) | <0.0001 |
Hyperlipidemia, n (%) | 900 (49%) | 129 (55%) | 0.09 |
Prior myocardial infarction, n (%) | 451 (25%) | 82 (35%) | 0.0006 |
Prior CABG, n (%) | 210 (11%) | 41 (18%) | 0.007 |
Prior PCI, n (%) | 450 (25%) | 66 (28%) | 0.22 |
Left ventricular ejection fraction (%) | 51 ± 11 | 41 ± 14 | <0.0001 |
STEMI, n (%) | 885 (48%) | 131 (56%) | 0.03 |
CA/PCI during hospitalization, n (%) | 1724 (94%) | 206 (88%) | 0.0006 |
Laboratory values at hospital admission | |||
Serum creatinine (mg/dL) | 1.0 ± 0.4 | 1.4 ± 0.9 | <0.0001 |
eGFR (ml/min/1.73m2) | 80 ± 26 | 63 ± 30 | <0.0001 |
Hemoglobin (g/dL) | 13.7 ± 1.8 | 13.1 ± 2.1 | <0.0001 |
Blood glucose (mg/dL) | 146 ± 57 | 192 ± 88 | <0.0001 |
hs-TnI (ng/L) | 5223 ± 20,634 | 12,992 ± 50,065 | <0.0001 |
Medication before hospital admission | |||
Aspirin, n (%) | 642 (35%) | 108 (46%) | 0.0009 |
Statins, n (%) | 601 (33%) | 90 (38%) | 0.11 |
Beta-blockers, n (%) | 632 (28%) | 100 (24%) | 0.01 |
ACE/AR blockers, n (%) | 718 (35%) | 93 (40%) | 0.89 |
Oral anticoagulants, n (%) | 91 (5%) | 17 (7%) | 0.29 |
In-hospital complications | |||
In-hospital death, n (%) | 9 (0.5%) | 30 (13%) | <0.0001 |
Cardiogenic shock, n (%) | 58 (3%) | 59 (25%) | <0.0001 |
Acute pulmonary edema, n (%) | 115 (6%) | 99 (42%) | <0.0001 |
Combined clinical endpoint, n (%) | 141 (8%) | 119 (51%) | <0.0001 |
Mechanical ventilation, n (%) | 32 (2%) | 46 (20%) | <0.0001 |
Atrial fibrillation, n (%) | 147 (8%) | 62 (26%) | <0.0001 |
VT/VF, n (%) | 127 (7%) | 41 (18%) | <0.0001 |
High-degree CD, n (%) | 60 (3%) | 14 (6%) | 0.04 |
Major bleeding, n (%) | 41 (2%) | 31 (13%) | <0.0001 |
ICCU length of stay (days) * | 4 (3–4) | 5 (4–8) | <0.001 † |
AUC (95% CI) | p Value AUC | p Value for AUC Comparison | NRI (95% CI) | p Value NRI | |
---|---|---|---|---|---|
Admission sCr | 0.66 (0.62–0.70) | <0.001 | - | - | - |
Admission hs-CRP + sCr | 0.72 (0.68–0.76) | <0.001 | <0.001 | 14% (10–17) | 0.01 |
Clinical predictors * | 0.79 (0.77–0.83) | <0.001 | - | - | - |
Admission hs-CRP + clinical predictors * | 0.81 (0.78–0.84) | <0.001 | 0.002 | 8% (3–12) | <0.001 |
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Cosentino, N.; Genovese, S.; Campodonico, J.; Bonomi, A.; Lucci, C.; Milazzo, V.; Moltrasio, M.; Biondi, M.L.; Riggio, D.; Veglia, F.; et al. High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study. J. Clin. Med. 2019, 8, 2192. https://doi.org/10.3390/jcm8122192
Cosentino N, Genovese S, Campodonico J, Bonomi A, Lucci C, Milazzo V, Moltrasio M, Biondi ML, Riggio D, Veglia F, et al. High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study. Journal of Clinical Medicine. 2019; 8(12):2192. https://doi.org/10.3390/jcm8122192
Chicago/Turabian StyleCosentino, Nicola, Stefano Genovese, Jeness Campodonico, Alice Bonomi, Claudia Lucci, Valentina Milazzo, Marco Moltrasio, Maria Luisa Biondi, Daniela Riggio, Fabrizio Veglia, and et al. 2019. "High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study" Journal of Clinical Medicine 8, no. 12: 2192. https://doi.org/10.3390/jcm8122192