Clinical Outcomes for Acute Kidney Injury in Acute Myocardial Infarction Patients After Intra-Aortic Balloon Pump Implantation: A Single-Center Observational Study

Overview

Journal Rev Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2024 Jul 30

PMID 39077525

Authors

Xin-Ying Zhang

Zhong-Guo Fan

Hai-Mei Xu

Ke Xu

Nai-Liang Tian

Affiliations

Soon will be listed here.

Abstract

Background: Acute kidney injury (AKI) is common after cardiac interventional procedures. The prevalence and clinical outcome of AKI in patients with acute myocardial infarction (AMI) after undergoing intra-aortic balloon pump (IABP) implantation remains unknown. The aim of this study was to investigate the incidence, risk factors, and prognosis of AKI in specific patient populations.

Methods: We retrospectively reviewed 319 patients with AMI between January 2017 and December 2021 and who had successfully received IABP implantation. The diagnostic and staging criteria used for AKI were based on guidelines from "Kidney Disease Improving Global Outcomes". The composite endpoint included all-cause mortality, recurrent myocardial infarction, rehospitalization for heart failure, and target vessel revascularization.

Results: A total of 139 patients (43.6%) developed AKI after receiving IABP implantation. These patients showed a higher incidence of major adverse cardiovascular events (hazard ratio [HR]: 1.55, 95% confidence interval [CI]: 1.06-2.26, = 0.022) and an increased risk of all-cause mortality (HR: 1.62, 95% CI: 1.07-2.44, = 0.019). Multivariable regression models found that antibiotic use (odds ratio [OR]: 2.07, 95% CI: 1.14-3.74, = 0.016), duration of IABP use (OR: 1.24, 95% CI: 1.11-1.39, 0.001) and initial serum creatinine (SCr) (OR: 1.01, 95% CI: 1.0-1.01, = 0.01) were independent risk factors for AKI, whereas emergency percutaneous coronary intervention was a protective factor (OR: 0.35, 95% CI: 0.18-0.69, = 0.003).

Conclusions: AMI patients who received IABP implantation are at high risk of AKI. Close monitoring of these patients is critical, including the assessment of renal function before and after IABP implantation. Additional preventive measures are needed to reduce the risk of AKI in these patients.

References

Mehran R, Aymong E, Nikolsky E, Lasic Z, Iakovou I, Fahy M . A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004; 44(7):1393-9. DOI: 10.1016/j.jacc.2004.06.068. View

Briguori C, Visconti G, Focaccio A, Airoldi F, Valgimigli M, Sangiorgi G . Renal Insufficiency After Contrast Media Administration Trial II (REMEDIAL II): RenalGuard System in high-risk patients for contrast-induced acute kidney injury. Circulation. 2011; 124(11):1260-9. DOI: 10.1161/CIRCULATIONAHA.111.030759. View

Dodson J, Hajduk A, Curtis J, Geda M, Krumholz H, Song X . Acute Kidney Injury Among Older Patients Undergoing Coronary Angiography for Acute Myocardial Infarction: The SILVER-AMI Study. Am J Med. 2019; 132(12):e817-e826. PMC: 6891160. DOI: 10.1016/j.amjmed.2019.05.022. View

Collet J, Thiele H, Barbato E, Barthelemy O, Bauersachs J, Bhatt D . 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2020; 42(14):1289-1367. DOI: 10.1093/eurheartj/ehaa575. View

Ghionzoli N, Sciaccaluga C, Mandoli G, Vergaro G, Gentile F, DAscenzi F . Cardiogenic shock and acute kidney injury: the rule rather than the exception. Heart Fail Rev. 2020; 26(3):487-496. PMC: 8024234. DOI: 10.1007/s10741-020-10034-0. View

Shacham Y, Leshem-Rubinow E, Gal-Oz A, Arbel Y, Keren G, Roth A . Relation of time to coronary reperfusion and the development of acute kidney injury after ST-segment elevation myocardial infarction. Am J Cardiol. 2014; 114(8):1131-5. DOI: 10.1016/j.amjcard.2014.07.032. View

Peek G, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany M . Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet. 2009; 374(9698):1351-63. DOI: 10.1016/S0140-6736(09)61069-2. View

Marenzi G, Ferrari C, Marana I, Assanelli E, De Metrio M, Teruzzi G . Prevention of contrast nephropathy by furosemide with matched hydration: the MYTHOS (Induced Diuresis With Matched Hydration Compared to Standard Hydration for Contrast Induced Nephropathy Prevention) trial. JACC Cardiovasc Interv. 2012; 5(1):90-7. DOI: 10.1016/j.jcin.2011.08.017. View

Yuan L, Nie S . Efficacy of Intra-aortic Balloon Pump before versus after Primary Percutaneous Coronary Intervention in Patients with Cardiogenic Shock from ST-elevation Myocardial Infarction. Chin Med J (Engl). 2016; 129(12):1400-5. PMC: 4910361. DOI: 10.4103/0366-6999.183428. View

10.

He X, Gao C . Peri-operative application of intra-aortic balloon pumping reduced in-hospital mortality of patients with coronary artery disease and left ventricular dysfunction. Chin Med J (Engl). 2019; 132(8):935-942. PMC: 6595768. DOI: 10.1097/CM9.0000000000000178. View

11.

Maioli M, Toso A, Gallopin M, Leoncini M, Tedeschi D, Micheletti C . Preprocedural score for risk of contrast-induced nephropathy in elective coronary angiography and intervention. J Cardiovasc Med (Hagerstown). 2010; 11(6):444-9. DOI: 10.2459/JCM.0b013e328335227c. View

12.

Bagur R, Webb J, Nietlispach F, Dumont E, De LaRochelliere R, Doyle D . Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic valve replacement. Eur Heart J. 2009; 31(7):865-74. PMC: 2848323. DOI: 10.1093/eurheartj/ehp552. View

13.

Ibanez B, James S, Agewall S, Antunes M, Bucciarelli-Ducci C, Bueno H . 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European.... Eur Heart J. 2017; 39(2):119-177. DOI: 10.1093/eurheartj/ehx393. View

14.

James M, Ghali W, Knudtson M, Ravani P, Tonelli M, Faris P . Associations between acute kidney injury and cardiovascular and renal outcomes after coronary angiography. Circulation. 2011; 123(4):409-16. DOI: 10.1161/CIRCULATIONAHA.110.970160. View

15.

Gonzalez L, Chaney M . Intraaortic Balloon Pump Counterpulsation, Part I: History, Technical Aspects, Physiologic Effects, Contraindications, Medical Applications/Outcomes. Anesth Analg. 2020; 131(3):776-791. DOI: 10.1213/ANE.0000000000004954. View

16.

Paolisso P, Bergamaschi L, Gragnano F, Gallinoro E, Cesaro A, Sardu C . Outcomes in diabetic patients treated with SGLT2-Inhibitors with acute myocardial infarction undergoing PCI: The SGLT2-I AMI PROTECT Registry. Pharmacol Res. 2022; 187:106597. PMC: 9946774. DOI: 10.1016/j.phrs.2022.106597. View

17.

Sinkovic A, Masnik K, Mihevc M . Predictors of acute kidney injury (AKI) in high-risk ST-elevation myocardial infarction (STEMI) patients: A single-center retrospective observational study. Bosn J Basic Med Sci. 2018; 19(1):101-108. PMC: 6387676. DOI: 10.17305/bjbms.2018.3797. View

18.

Wang K, Li Z, Sun Y, Liu X, Ma W, Ding Y . Dapagliflozin Improves Cardiac Function, Remodeling, Myocardial Apoptosis, and Inflammatory Cytokines in Mice with Myocardial Infarction. J Cardiovasc Transl Res. 2021; 15(4):786-796. DOI: 10.1007/s12265-021-10192-y. View

19.

Marfella R, Sardu C, Balestrieri M, Siniscalchi M, Minicucci F, Signoriello G . Effects of incretin treatment on cardiovascular outcomes in diabetic STEMI-patients with culprit obstructive and multivessel non obstructive-coronary-stenosis. Diabetol Metab Syndr. 2018; 10:1. PMC: 5751832. DOI: 10.1186/s13098-017-0304-3. View

20.

Marfella R, Rizzo M, Siniscalchi M, Paolisso P, Barbieri M, Sardu C . Peri-procedural tight glycemic control during early percutaneous coronary intervention up-regulates endothelial progenitor cell level and differentiation during acute ST-elevation myocardial infarction: effects on myocardial salvage. Int J Cardiol. 2013; 168(4):3954-62. DOI: 10.1016/j.ijcard.2013.06.053. View