Early prediction of acute kidney injury in patients with acute myocardial injury
Journal of Critical Care, 07/05/2012
Hsiao PG et al. – The worse Thrombolysis in Myocardial Infarction (TIMI) flow and high plasma cystatin C can be used to predict acute kidney injury (AKI) after acute myocardial infarction (AMI). Moreover, IL–6 can also be used as a 30–day major cardiovascular event indicator after AMI.Methods
- This prospective study was conducted from November 2009 to January 2011 and enrolled sequential 96 patients with catheter–proven AMI; it was approved by the institutional review board of Chang Gung Memorial Hospital, Taiwan and conformed to the tenets of the Declaration of Helsinki.
- The definition of AKI is the elevation of serum creatinine of more than 0.3mg/dL within 48hours.
- The results show that the incidence of AKI after AMI is 17.7% (17 patients).
- The following could be statistically related to AKI after AMI: age (P=.012), cardiac functions (Killip stage and echocardiogram; P=.003 each), Thrombolysis in Myocardial Infarction (TIMI) flow grade (P<.001), stenting (P<.001), neutrophil gelatinase–associated lipocalin (P=.005), IL–6 (P=.01), IL–18 (P=.002), and cystatin C (P=.002) in serum.
- The TIMI flow grade and serum cystatin C were shown to be important predictors by using multivariate analysis.
- Both TIMI flow lower than grade 2 and serum cystatin C of more than 1364mg/L could be used to predict AKI (both overall correctness, 0.78).
- Moreover, IL–6 in serum is also associated with the major cardiovascular events after AMI (P=.02), as demonstrated in the study.