Abstract: SA-PO061
AKI by KDIGO and AKIN Criteria in Patients with Non-ST Elevation Myocardial Infarction: Association with Risk Scores
Session Information
- AKI Clinical: Biomarkers and Dialysis
November 04, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Acute Kidney Injury
- 003 AKI: Clinical and Translational
Authors
- Gokhale, Avantee V, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States
- Yu, Samuel Mon-Wei, Jacobi Medical Center, Bronx, New York, United States
- Alvarado verduzco, Hector, JACOBI MEDICAL CENTER, BRONX, New York, United States
- Nissaisorakarn, Pitchaphon, Jacobi Medical Center, Bronx, New York, United States
- Mahato, Poonam, Jacobi Medical Center, Bronx, New York, United States
- Acharya, Anjali, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States
Background
Acute kidney injury (AKI) is commonly associated with the acute coronary syndrome, both STEMI and NSTEMI. We aimed to assess the incidence of AKI, as defined by AKIN and KDIGO criteria, in patients with NSTEMI at a safety net hospital catering to minority populations, and examined the association between the scores used for risk stratification in NSTEMI and AKI.
Methods
170 out of 296 consecutively admitted patients between 1.1.2015 and 7.1.2016 with a primary diagnosis of NSTEMI were included in this study. 126 were excluded, mainly due to primary diagnosis of STEMI, and transfer to outside hospital. Their data were collected by retrospective chart reviews. GRACE and Killip scores were calculated for NSTEMI characterization. AKI was assessed as present/absent by 2 different criteria viz. AKIN and KDIGO. Statistical analyses included descriptive statistics and multivariable logistic regression.
Results
Out of 170 patients (mean age=69, 56% males), 39% were Hispanic. 28% had CKD, while, hypertension prevalence was 84%. Median baseline serum creatinine in the study group was 0.9. Median GRACE score was 119 and majority patients fell under Killip class 1 (78%). KDIGO and AKIN scores diagnosed AKI in equal number of NSTEMI patients (45%). While Killip class failed to predict AKI, GRACE score significantly associated with AKI by both AKI criteria [OR 1.03, 95% CI 1.01-1.04; p<0.001 for both]. Finally, when adjusted for age, sex, ACE-inhibitor, aspirin, statin, beta-blocker, diuretic use, history of diabetes and contrast exposure, GRACE score remained significantly associated with AKI by both criteria [1.03 (1.01-1.05), p=0.001 for both].
Conclusion
In a single-center, inner-city safety net hospital cohort of NSTEMI patients with predominantly Hispanic population, GRACE score, which incorporates initial creatinine into the score, was associated with AKI after adjustment for traditional risk factors for AKI. Furthermore, contrary to observations in STEMI, both AKIN and KDIGO predicted AKI to a similar extent in NSTEMI patients. However, larger population-based prospective studies are needed to confirm our findings and further assess the association with mortality.