Impact of Continuous Deterioration of Kidney Function 6 to 8聽Months After Percutaneous Coronary Intervention for Acute Coronary Syndrome

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• 作者：Naohiko Nemoto ; MD ; PhD^a ; ^{naohiko-0620@nifty.com" class="auth_mail} ; Masaki Iwasaki ; MD^b ; Mami Nakanishi ; MD^a ; Tadashi Araki ; MD^a ; Makoto Utsunomiya ; MD^a ; Masaki Hori ; MD^a ; Nobutaka Ikeda ; MD ; PhD^a ; Kunihiko Makino ; MD ; PhD^a ; Hideki Itaya ; MD ; PhD^a ; Raisuke Iijima ; MD ; PhD^a ; Hidehiko Hara ; MD ; PhD^a ; Takuro Takagi ; MD^a ; Nobuhiko Joki ; MD ; PhD^b ; Kaoru Sugi ; MD ; PhD^a ; Masato Nakamura ; MD ; PhD^a
• 刊名：The American Journal of Cardiology
• 出版年：15 May 2014
• 年：2014
• 卷：113
• 期：10
• 页码：1647-1651
• 全文大小：389 K

文摘

Preprocedural chronic kidney disease and contrast-induced acute kidney injury are predictors of in-hospital death and long-term mortality. However, neither the time course of kidney function after percutaneous coronary intervention (PCI) nor the relation between the time course of kidney function and prognosis has been adequately studied. We studied 531 patients who underwent PCI for acute coronary syndrome. The continuous deterioration of kidney function (CDKF) was defined as a >25% increase in serum creatinine level or serum creatinine >0.5 mg/dl above baseline at 6 to 8 months after PCI. CDKF was observed in 87 patients (16.4%). Independent risk factors for CDKF were contrast-induced acute kidney injury, preprocedural hemoglobin level, and proteinuria. Patients with CDKF exhibited significant higher 5-year mortality rate than patients without CDKF (25% vs 9.4%, log-rank p = 0.0006). Independent risk factors for 5-year mortality were age >75 year, anemia, New York Heart Association class III or IV, low ejection fraction, and CDKF. CDKF is associated with an increased risk of all-cause mortality of 5 years in patients with acute coronary syndrome undergoing PCI.