THE EFFECT OF ACUTE KIDNEY INJURY IN ELDERLY PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION

Y SAOOD; A SALMAN; MI KHAN; KA YOUNIS

doi:10.54112/bcsrj.v2023i1.444

Authors

Y SAOOD Department of Cardiology, Ayub Teaching Hospital Abbottabad, Pakistan
A SALMAN Department of Cardiology, Saidu Medical College / Saidu Group of Teaching Hospital Swat, Pakistan
MI KHAN Department of Cardiology, Peshawar Institute of Cardiology, Pakistan
KA YOUNIS Department of Cardiology, Aadil Hospital Lahore, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.444

Keywords:

Percutaneous coronary intervention, Acute kidney injury, elderly people

Abstract

This study aims to determine the frequency of acute kidney injury (AKI) in patients who undergo percutaneous coronary intervention (PCI) and its impact on elderly patients. To achieve this, 80 patients admitted to Ayub Teaching Hospital from March 2019 to August 2020 for PCI were studied for AKI after the procedure. The primary endpoint was mortality from all causes, while the secondary was mortality due to major cardiovascular events. The results showed that out of the 80 patients, 29 developed AKI, with a higher incidence observed in the older age group. These patients reported a higher rate of congestive heart failure, increased C-reactive proteins, and an increased rate of major adverse cardiovascular events, which was 39.43%. Furthermore, all-cause mortality was higher in patients suffering from AKI. In conclusion, this study highlights that one-fourth of elderly patients undergoing PCI face a higher risk of AKI. Further research is required to mitigate the mortality and morbidity associated with AKI in this vulnerable group.

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References

Cury, R. C., Leipsic, J., Abbara, S., Achenbach, S., Berman, D., Bittencourt, M., Budoff, M., Chinnaiyan, K., Choi, A. D., Ghoshhajra, B., Jacobs, J., Koweek, L., Lesser, J., Maroules, C., Rubin, G. D., Rybicki, F. J., Shaw, L. J., Williams, M. C., Williamson, E., White, C. S., … Blankstein, R. (2022). CAD-RADS™ 2.0 - 2022 Coronary Artery Disease-Reporting and Data System: An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Cardiology (ACC), the American College of Radiology (ACR), and the North America Society of Cardiovascular Imaging (NASCI). Journal of cardiovascular computed tomography, 16(6), 536–557

Wang KY, Zheng YY, Wu TT, Ma YT, Xie X. Predictive Value of Gensini Score in the Long-Term Outcomes of Patients With Coronary Artery Disease Who Underwent PCI. Front Cardiovasc Med. 2022 Jan 24;8:778615. doi: 10.3389/fcvm.2021.778615. PMID: 35141291; PMCID: PMC8818732.

Valgimigli, M., Frigoli, E., Heg, D., Tijssen, J., Jüni, P., Vranckx, P., Ozaki, Y., Morice, M. C., Chevalier, B., Onuma, Y., Windecker, S., Tonino, P. A. L., Roffi, M., Lesiak, M., Mahfoud, F., Bartunek, J., Hildick-Smith, D., Colombo, A., Stanković, G., Iñiguez, A., … MASTER DAPT Investigators (2021). Dual Antiplatelet Therapy after PCI in Patients at High Bleeding Risk. The New England journal of medicine, 385(18), 1643–1655.

Abtan, J., Wiviott, S. D., Sorbets, E., Popovic, B., Elbez, Y., Mehta, S. R., Sabatine, M. S., Bode, C., Pollack, C. V., Cohen, M., Moccetti, T., Laanmets, P., Faxon, D., Okreglicki, A., Ducrocq, G., Steg, P. G., & TAO investigators (2021). Prevalence, clinical determinants and prognostic implications of coronary procedural complications of percutaneous coronary intervention in non-ST-segment elevation myocardial infarction: Insights from the contemporary multinational TAO trial. Archives of cardiovascular diseases, 114(3), 187–196.

Mehran, R., Owen, R., Chiarito, M., Baber, U., Sartori, S., Cao, D., Nicolas, J., Pivato, C. A., Nardin, M., Krishnan, P., Kini, A., Sharma, S., Pocock, S., & Dangas, G. (2021). A contemporary simple risk score for prediction of contrast-associated acute kidney injury after percutaneous coronary intervention: derivation and validation from an observational registry. Lancet (London, England), 398(10315), 1974–1983

Ono M, Serruys PW, Hara H, Kawashima H, Gao C, Wang R, Takahashi K, O’Leary N, Wykrzykowska JJ, Sharif F, Piek JJ. 10-Year follow-up after revascularization in elderly patients with complex coronary artery disease. Journal of the American College of Cardiology. 2021 Jun 8;77(22):2761-73.

Wei X, Chen H, You Z, Yang J, He H, He C, Zheng W, Lin K, Jiang F. Nutritional status and risk of contrast-associated acute kidney injury in elderly patients undergoing percutaneous coronary intervention. Clinical and Experimental Nephrology. 2021 Sep;25:953-62.

Valle JA, McCoy LA, Maddox TM, Rumsfeld JS, Ho PM, Casserly IP, Nallamothu BK, Roe MT, Tsai TT, Messenger JC. Longitudinal risk of adverse events in patients with acute kidney injury after percutaneous coronary intervention: insights from the National Cardiovascular Data Registry. Circulation: Cardiovascular Interventions. 2017 Apr;10(4):e004439.

He H, You Z, Lin X, He C, Zhang S, Luo M, Lin M, Zhang L, Lin K, Guo Y. A comparison between two definitions of contrast-associated acute kidney injury for long-term mortality in elderly and non-elderly patients after elective percutaneous coronary intervention. Frontiers in Cardiovascular Medicine. 2021 Sep 27;8:720857.

Lin C, Lin K, Guo Y, You Z, Zheng W, Lin F, Guo T, Zhu P. Low free triiodothyronine is associated with contrast-induced acute kidney injury and long-term outcome in elderly patients who underwent percutaneous coronary intervention. Anatolian Journal of Cardiology. 2019 Feb;21(2):60.

Mosenye SM, Moshomo T, Shailemo D, Rwegerera GM. The prevalence, associated factors and clinical outcomes of acute kidney injury among elderly patients admitted in medical wards of Princess Marina Hospital, Gaborone, Botswana. Tanzania Journal of Health Research. 2023 Mar 26;24(2):37-56.

Guo W, Liu J, He Y, Lei L, Guo Z, Song F, Zhou Z, Liu W, Zhong X, Chen S, Rao L. The Impact of Contrast-Associated Acute Kidney Injury on All-Cause Mortality in Older Patients After Coronary Angiography: A 7.5-year Follow-Up. Angiology. 2023 Feb 7:00033197231155610.

Ammar A, Khowaja S, Kumar R, Kumar V, Hussain A, Ahmed S, Siddiqui MN, Rasool M, Sial JA, Saghir T. Significance of Left Ventricular End Diastolic Pressure for Risk Stratification of Contrast-Induced Acute Kidney Injury after Primary Percutaneous Coronary Intervention. Pakistan Heart Journal. 2022 Sep 29;55(3):247-52.

Kumar R, Memon AU, Shaikh AH, Huma Z, Kumar V, Hussain A, Sial JA, Saghir T, Achakzai AS, Karim M. Timi Risk Index, A Simple Tool In Emergency Percutaneous Revascularization For The Prediction Of Contrast Induced Nephropathy. Journal of Ayub Medical College Abbottabad-Pakistan. 2022 Oct 1;34(4).

Holzmann MJ, Siddiqui AJ. Outcome of percutaneous coronary intervention during non–ST‐segment–elevation myocardial infarction in elderly patients with chronic kidney disease. Journal of the American Heart Association. 2020 Jun 16;9(12):e015084.

Montalescot, G., Sechtem, U., Achenbach, S., Andreotti, F., Arden, C., Budaj, A., Bugiardini, R., Crea, F., Cuisset, T., Di Mario, C., Ferreira, J. R., Gersh, B. J., Gitt, A. K., Hulot, J. S., Marx, N., Opie, L. H., Pfisterer, M., Prescott, E., Ruschitzka, F., … Zamorano, J. L. (2013). 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. European heart journal, 34(38), 2949–3003.

Roffi, M., Patrono, C., Collet, J. P., Mueller, C., Valgimigli, M., Andreotti, F., Bax, J. J., Borger, M. A., Brotons, C., Chew, D. P., Gencer, B., Hasenfuss, G., Kjeldsen, K., Lancellotti, P., Landmesser, U., Mehilli, J., Mukherjee, D., Storey, R. F., Windecker, S., & ESC Scientific Document Group (2016). 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). European heart journal, 37(3), 267–315.

Wang, N., Wang, P., Li, W., Jiang, L., Wang, M., Zhu, B., & Xi, X. (2022). Prognostic significance of malnutrition risk in elderly patients with acute kidney injury in the intensive care unit. BMC nephrology, 23(1), 335.

Miura, T., Miyashita, Y., Motoki, H., Kobayashi, H., Kobayashi, M., Nakajima, H., Kimura, H., Akanuma, H., Mawatari, E., Sato, T., Hotta, S., Kamiyoshi, Y., Maruyama, T., Watanabe, N., Eisawa, T., Aso, S., Hashizume, N., Ebisawa, S., & Ikeda, U. (2017). Efficacy and Safety of Percutaneous Coronary Intervention for Elderly Patients in the Second-Generation Drug-Eluting Stent Era: The SHINANO Registry. Angiology, 68(8), 688–697

Davenport, M. S., Perazella, M. A., Yee, J., Dillman, J. R., Fine, D., McDonald, R. J., Rodby, R. A., Wang, C. L., & Weinreb, J. C. (2020). Use of Intravenous Iodinated Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation. Radiology, 294(3), 660–668.

Chen, H., He, C., You, Z., Zhang, S., He, H., Chen, X. N., Wang, S., Lin, K., & Guo, Y. (2021). Association between urine pH and risk of contrast-associated acute kidney injury among patients after emergency percutaneous coronary intervention: a V-shape relationship?. Clinical and experimental nephrology, 25(5), 554–561.

Li, C., Xu, L., Guan, C., Zhao, L., Luo, C., Zhou, B., Zhang, X., Wang, J., Zhao, J., Huang, J., Li, D., Luan, H., Man, X., Che, L., Wang, Y., Zhang, H., & Xu, Y. (2020). Malnutrition screening and acute kidney injury in hospitalised patients: a retrospective study over a 5-year period from China. The British journal of nutrition, 123(3), 337–346.

Cai, Z. M., Wu, Y. Z., Chen, H. M., Feng, R. Q., Liao, C. W., Ye, S. L., Liu, Z. P., Zhang, M. M., & Zhu, B. L. (2020). Being at risk of malnutrition predicts poor outcomes at 3 months in acute ischemic stroke patients. European journal of clinical nutrition, 74(5), 796–805.

McCarthy, M. S., & Phipps, S. C. (2014). Special nutrition challenges: current approach to acute kidney injury. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 29(1), 56–62.

Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., Graham, I. M., Halliday, A., Landmesser, U., Mihaylova, B., Pedersen, T. R., Riccardi, G., Richter, D. J., Sabatine, M. S., Taskinen, M. R., Tokgozoglu, L., … ESC Scientific Document Group (2020). 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. European heart journal, 41(1), 111–188

Noh HW, Jeon Y, Kim JH, Lee GY, Jeon SJ, Kim KY, Lim JH, Jung HY, Choi JY, Park SH, Kim CD, Kim YL, Cho JH. Higher Serum Total Cholesterol to High-Density Lipoprotein Cholesterol Ratio Is Associated with Increased Mortality among Incident Peritoneal Dialysis Patients, Nutrients. 2021 Dec 29; 14(1):144