One-Year Mortality of Acute Kidney Injury in Patients with Acute Myocardial Infarction

Lim, Dae Hun; Jeong, Jong Hyeok; Jeong, Ji Min; Kim, Chang Seong; Choi, Joon Seok; Park, Jeong Woo; Bae, Eun Hui; Ma, Seong Kwon; Kim, Soo Wan

Abstract

PURPOSE
Acute kidney injury (AKI) is a common complication during hospitalization and is an accepted risk factor for in-hospital mortality. However, the association of severity of AKI with the long-term risk of death is not well known. This study aimed to investigate the incidence and clinical significance of AKI in patients with acute myocardial infarction (AMI).
METHODS
To examine the effect of the severity of AKI on 1-year risk of death following AMI, we performed an observational study of 1,224 patients admitted for AMI. We evaluated the association between AKI and all-cause mortality. Patients with maintaining hemodialysis treatment (n=7), and who died during hospitalization (n=71) were excluded. Remaining 1146 patients were divided into three groups according to the Acute Kidney Injury Network (AKIN) criteria (Stage-1, -2, and-3). The primary end point of the study was 1-year all-cause mortality after hospital discharge. The relation between the severity of AKI and 1-year mortality after AMI was analyzed.
RESULTS
AKI was developed in 222/1,146 (19.3%) patients during the hospital stay. Adjusted hazard ratio for 1-year mortality was 3.064 (95% CI 1.618 to 5.803, p=0.001), 6.112 (95% CI 2.344 to 15.935, p<0.001) and 20.030 (95% CI 5.428 to 73.912, p<0.001) in stage-1, -2, and stage-3 AKI groups compared with that of no AKI group.
CONCLUSION
The severity of AKI is strongly related to 1-year all cause mortality in patients with AMI.