关键词: 急性心肌梗死, 急性肾损伤, 流行病学, 患病率

Abstract:

【Abstract】 Objective：We performed a prospective, observational, single center cohort study to determine the rate, severity, risk-factors and characteristics of non-cardiac surgery associated acute kidney injury (AKI) in acute myocardial infarction (AMI) patients. Methodology: We retrospectively studied adult AMI patients hospitalized in teaching hospital, and started from January 2008, and completed in December 2012. There were a total of 1655 AMI patients, and 1371 were data completed. We chose patients as a group who developed AKI, neither after cardioangiography (CAG) nor coronary artery bypass grafting (CABG), and its control group. In this study, AKI was defined according to KDIGO AKI criteria. Thus, 656 patients were enrolled in this study. The demographics, medical history, diagnosis and management of AMI, laboratory parameters and treatment before AKI of the patients with and without AKI were collected. Simple and multiple logistic regression models were used to evaluate independent risk factors of AKI. Results: They were 433 males and 223 females with a median age of 74 years. Among them, 228 (34.8%) developed AKI. Neither cardiac nor renal function was found better in the AKI group. After adjusting for gender and age, multifactor retrospective analysis showed that decreased baseline estimated glomerular filtration rate (eGFR) (adjusted odds ratio [OR]= 2.049, 95% confidence interval [CI] 1.246-3.370, P=0.005), increased fasting plasma glucose (FPG) (adjusted OR=1.070, 95%CI 1.018-1.124, P=0.007), diuretics (adjusted OR=1.867, 95%CI 1.220-2.856, P=0.019) and Killip Grade 4 (adjusted OR=1.362, 95%CI 1.059-3.170, P=0.047) were independent risk factors of AKI, while increased diastolic blood pressure (DBP) on admission exhibited a lower adjusted OR value (adjusted OR=0.986, 95%CI 0.974-0.998, P=0.029), for patients of AKI neither happened after CAG nor CABG. Conclusion: AKI is a common complication and associated with increase in mortality after AMI. Decreased baseline renal function, increased FPG, diuretics and Killip Grade 4 were independently risk factors of AKI after conservative and strategies.

Key words: AMI, AKI, Epidemiology, Prevalence