AKI at 12 and 24 Hours After PCI Independently Ups Death Risk
Timing of AKI after urgent percutaneous coronary intervention affects risk of significant kidney function loss 1 year after the procedure.
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NEW ORLEANS—Acute kidney injury (AKI) occurring 12 and 24 hours after urgent percutaneous coronary intervention (PCI) is independently associated with a similar elevated risk of death, researchers reported at the American Society of Nephrology's Kidney Week 2017 meeting.
AKI occurring 24 hours after PCI is more strongly associated with subsequent significant loss of kidney function at 1 year compared with AKI occurring at 12 hours.
Thida C. Tan, MD, of Kaiser Permanente Northern California (KPNC) in Oakland, California, and colleagues studied 8522 patients who underwent urgent PCI within KPNC from 2008 to 2013. Physicians documented AKI in 1.8% of patients at 12 hours and 1.6% at 24 hours post-PCI. Patients with AKI at 12 and 24 hours had a 3.3 and 3.7 times increased risk of all-cause mortality up to 1 year, respectively, compared those who did not have AKI, Dr Tan's group reported. In addition, AKI at 24 hours post-PCI was associated with a 4.6 times increased risk of significant loss of kidney function, whereas AKI at 12 hours was associated with a 2.3 times increased risk.
The investigators defined AKI as a 50% or greater relative increase or 0.3 mg/dL or greater increase serum creatinine after PCI compared with before PCI. They defined significant loss of kidney function as a 50% or greater decline in estimated glomerular filtration rate compared with baseline.
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Tan TC, Leong T, Lundstrom RJ, et al. Timing of AKI after urgent percutaneous coronary intervention and adverse outcomes: The PATTERN Study. Data presented in poster format at Kidney Week 2017 in New Orleans (Oct. 31 to Nov. 5). Poster FR-PO050.