Impact of Acute Renal Failure on In-Hospital Outcomes Following Percutaneous Treatment of Acute Myocardial Infarction

ABSTRACTBackgroundAcute renal failure (ARF) is a possible complication after percutaneous coronary intervention (PCI). The objective of this study was to evaluate the occurrence and prognostic impact of ARF after PCI in patients with ST segment elevation myocardial infarction (STEMI).MethodsSingle-center registry evaluating in-hospital outcomes of 501 patients admitted with STEMI undergoing primary, rescue or late PCI. The incidence and predictors of ARF after PCI were evaluated.ResultsMean age was 60.7±12.6years and 67% were male. The populaton had high cardiovascular risk characteristics, with 30% of diabetics and 7.4% with preexisting chronic kidney disease (CKD). The left anterior descending artery was the culprit vessel in 49.4% of the cases and 15% of patients had Killip class III or IV. ARF was observed in 24.7% of patients, who were significantly older, had more diabetes, history of CKD or heart failure, had higher enzyme elevation and lower ejection fraction when compared to those without ARF. In-hospital mortality was higher in patients who developed ARF (29% vs. 4.8%; P<0.01). Independent predictors of ARF were age>76 years, previous CKD, Killip class III or IV, need of vascular surgery or blood transfusion.ConclusionsAcute renal failure after PCI in STEMI was a frequent complication and was associated with increased in-hospital mortality