Abstract: SA-PO054

Effect of Community Acquired AKI on Long Term Outcomes in Patients Presenting with an Acute Myocardial Infarction

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Mathew, Roy, William Jennings Bryan Dorn VAMC, Blythewood, South Carolina, United States
  • Sidhu, Mandeep S., Albany Medical College, Stratton VAMC, Albany Medical Center, Albany, New York, United States
  • Othersen, Jennifer, WJB Dorn VA Medical Center, Columbia, South Carolina, United States
  • Moran, Robert R, USC , Columbia, South Carolina, United States
  • Asif, Arif, Jersey Shore University Medical Center, Neptune, New Jersey, United States
  • Bangalore, Sripal, New York University School of Medicine, New York, New York, United States
Background

We sought to examine long-term outcomes in patients admitted for a myocardial infarction (MI) based on whether they experienced community acquired acute kidney injury (CAAKI), hospital acquired acute kidney injury (HAAKI), or no acute kidney injury (no AKI).

Methods

Methods: Retrospective parallel cohort analysis of Veterans admitted for acute MI between 2005 and 2008. Data was obtained from the corporate data warehouse (CDW) using the VA Informatics and Computing Infrastructure (VINCI) computing environment. AKI was determined by assessing for changes in serum creatinine according to the KDIGO AKI classification system. Outcomes were death, hospitalization for cardiovascular (CV) events (MI, congestive heart failure, or stroke).

Results

Results: 11,580 patients with an MI were identified. Of these patients 15.1% had CAAKI, 14.5% had HAAKI and 70.4% had no AKI. Patients who developed AKI (CAAKI or HAAKI) were older, and had greater number of comorbidities as well as severity of initial admission (ICU stay, ventilation requirement or dialysis requirement) than no AKI. Patients with CAAKI were less likely to get cardiac catheterization during admission than those with HAAKI or no AKI (44.7%, 57.9%, 67.3%, respectively, p<0.001). Mortality was higher in both AKI groups as compared to the no AKI group at 5 year follow-up (adjusted HR and 95%CI: CAAKI 1.96, 1.83-2.09; HAAKI 1.60, 1.50-1.72). Patients with AKI (CA or HA) were more likely to have a repeat CV hospitalization than patients with no AKI (CAAKI adjusted HR 1.14 p=0.004; HAAKI adjusted HR 1.11, p=0.02; no difference between AKI groups).

Conclusion

Conclusions: In patients admitted with an acute MI, the presence of CAAKI was associated with long term outcomes as poor as HAAKI. Further research is needed to understand these associations.

Funding

  • Veterans Affairs Support