Association Between Acidosis Soon After Reperfusion and Contrast‐Induced Nephropathy in Patients With a First‐Time ST‐Segment Elevation Myocardial Infarction
BackgroundContrast‐induced nephropathy (CIN) is associated with poor outcomes in patients with acute myocardial infarction. However, the predictors of CIN have yet to be fully elucidated. Methods and ResultsThe study included 273 consecutive patients with a first‐time ST‐segment elevation myocardial...
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| Format: | Article |
| Language: | English |
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Wiley
2017-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.006380 |
| _version_ | 1818312078200406016 |
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| author | Masaomi Gohbara Azusa Hayakawa Yusuke Akazawa Shuta Furihata Ai Kondo Yusuke Fukushima Sakie Tomari Tsutomu Endo Kazuo Kimura Kouichi Tamura |
| author_facet | Masaomi Gohbara Azusa Hayakawa Yusuke Akazawa Shuta Furihata Ai Kondo Yusuke Fukushima Sakie Tomari Tsutomu Endo Kazuo Kimura Kouichi Tamura |
| author_sort | Masaomi Gohbara |
| collection | DOAJ |
| description | BackgroundContrast‐induced nephropathy (CIN) is associated with poor outcomes in patients with acute myocardial infarction. However, the predictors of CIN have yet to be fully elucidated. Methods and ResultsThe study included 273 consecutive patients with a first‐time ST‐segment elevation myocardial infarction who underwent reperfusion within 12 hours of symptom onset. The exclusion criteria were hemodialysis, mechanical ventilation, or previous coronary artery bypass grafting. All patients underwent arterial blood gas analysis soon after reperfusion. CIN was defined as an increase of 0.5 mg/dL in serum creatinine or a 25% increase from baseline between 48 and 72 hours after contrast medium exposure. Acidosis was defined as an arterial blood pH <7.35. CIN was observed in 35 patients (12.8%). Multivariable logistic regression analysis with forward stepwise algorithm revealed a significant association between CIN and the following: reperfusion time, the prevalence of hypertension, peak creatine kinase‐MB, high‐sensitivity C‐reactive protein on admission, and the incidence of acidosis (P<0.05). Multivariable logistic regression analysis revealed that the incidence of acidosis was associated with CIN when adjusted for age, male sex, body mass index, amount of contrast medium used, estimated glomerular filtration rate on admission, glucose level on admission, high‐sensitivity C‐reactive protein on admission, and left ventricular ejection fraction (P<0.05). Moreover, the incidence of acidosis was associated with CIN when adjusted for the Mehran CIN risk score (odds ratio: 2.229, P=0.049). ConclusionsThe incidence of acidosis soon after reperfusion was associated with CIN in patients with a first‐time ST‐segment elevation myocardial infarction. |
| first_indexed | 2024-12-13T08:12:08Z |
| format | Article |
| id | doaj.art-0b2b5c28300a45259d9e2b85cebe31b9 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T08:12:08Z |
| publishDate | 2017-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-0b2b5c28300a45259d9e2b85cebe31b92022-12-21T23:54:12ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-08-016810.1161/JAHA.117.006380Association Between Acidosis Soon After Reperfusion and Contrast‐Induced Nephropathy in Patients With a First‐Time ST‐Segment Elevation Myocardial InfarctionMasaomi Gohbara0Azusa Hayakawa1Yusuke Akazawa2Shuta Furihata3Ai Kondo4Yusuke Fukushima5Sakie Tomari6Tsutomu Endo7Kazuo Kimura8Kouichi Tamura9Division of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, JapanDivision of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, JapanDivision of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, JapanDivision of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, JapanDivision of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, JapanDivision of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, JapanDivision of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, JapanDivision of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, JapanDivision of Cardiology, Yokohama City University Medical Center, Yokohama, JapanDepartment of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, JapanBackgroundContrast‐induced nephropathy (CIN) is associated with poor outcomes in patients with acute myocardial infarction. However, the predictors of CIN have yet to be fully elucidated. Methods and ResultsThe study included 273 consecutive patients with a first‐time ST‐segment elevation myocardial infarction who underwent reperfusion within 12 hours of symptom onset. The exclusion criteria were hemodialysis, mechanical ventilation, or previous coronary artery bypass grafting. All patients underwent arterial blood gas analysis soon after reperfusion. CIN was defined as an increase of 0.5 mg/dL in serum creatinine or a 25% increase from baseline between 48 and 72 hours after contrast medium exposure. Acidosis was defined as an arterial blood pH <7.35. CIN was observed in 35 patients (12.8%). Multivariable logistic regression analysis with forward stepwise algorithm revealed a significant association between CIN and the following: reperfusion time, the prevalence of hypertension, peak creatine kinase‐MB, high‐sensitivity C‐reactive protein on admission, and the incidence of acidosis (P<0.05). Multivariable logistic regression analysis revealed that the incidence of acidosis was associated with CIN when adjusted for age, male sex, body mass index, amount of contrast medium used, estimated glomerular filtration rate on admission, glucose level on admission, high‐sensitivity C‐reactive protein on admission, and left ventricular ejection fraction (P<0.05). Moreover, the incidence of acidosis was associated with CIN when adjusted for the Mehran CIN risk score (odds ratio: 2.229, P=0.049). ConclusionsThe incidence of acidosis soon after reperfusion was associated with CIN in patients with a first‐time ST‐segment elevation myocardial infarction.https://www.ahajournals.org/doi/10.1161/JAHA.117.006380acidosiscontrast‐induced nephropathyST‐segment elevation myocardial infarction |
| spellingShingle | Masaomi Gohbara Azusa Hayakawa Yusuke Akazawa Shuta Furihata Ai Kondo Yusuke Fukushima Sakie Tomari Tsutomu Endo Kazuo Kimura Kouichi Tamura Association Between Acidosis Soon After Reperfusion and Contrast‐Induced Nephropathy in Patients With a First‐Time ST‐Segment Elevation Myocardial Infarction Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acidosis contrast‐induced nephropathy ST‐segment elevation myocardial infarction |
| title | Association Between Acidosis Soon After Reperfusion and Contrast‐Induced Nephropathy in Patients With a First‐Time ST‐Segment Elevation Myocardial Infarction |
| title_full | Association Between Acidosis Soon After Reperfusion and Contrast‐Induced Nephropathy in Patients With a First‐Time ST‐Segment Elevation Myocardial Infarction |
| title_fullStr | Association Between Acidosis Soon After Reperfusion and Contrast‐Induced Nephropathy in Patients With a First‐Time ST‐Segment Elevation Myocardial Infarction |
| title_full_unstemmed | Association Between Acidosis Soon After Reperfusion and Contrast‐Induced Nephropathy in Patients With a First‐Time ST‐Segment Elevation Myocardial Infarction |
| title_short | Association Between Acidosis Soon After Reperfusion and Contrast‐Induced Nephropathy in Patients With a First‐Time ST‐Segment Elevation Myocardial Infarction |
| title_sort | association between acidosis soon after reperfusion and contrast induced nephropathy in patients with a first time st segment elevation myocardial infarction |
| topic | acidosis contrast‐induced nephropathy ST‐segment elevation myocardial infarction |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.006380 |
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