Very few studies evaluated the impact of acute kidney injury (AKI) and chronic kidney
disease (CKD) on heart failure (HF) hospitalization risk following an acute myocardial
infarction (AMI). For this retrospective cohort analysis, we identified adult AMI survivors from January
to June 2014 from the United States Nationwide Readmissions Database. Outcomes were
a 6-month HF, fatal HF, composite of HF during the AMI or a 6-month HF, and a composite
of 6-month HF or death during a non–HF-related admission. We analyzed differences
in outcomes across categories of patients without renal injury, AKI without CKD, stable
CKD, AKI on CKD, and end-stage renal disease (ESRD). Of 237,549 AMI survivors, AKI
was present in 13.8%, CKD in 16.5%, ESRD in 3.4%, and AKI on CKD in 7.7%. Patients
with renal failure had lower coronary revascularization rates and higher in-hospital
HF. A 6-month HF hospitalization occurred in 12,934 patients (5.4%). Compared with
patients without renal failure (3.3%), 6-month HF admission rate was higher in patients
with AKI on CKD (14.6%; odds ratio [OR] 1.99; 95% confidence interval [CI] 1.81 to
2.19), ESRD (11.2%; OR 1.57; 95% CI 1.36 to 1.81), stable CKD (10.7%; OR 1.72; 95%
CI 1.56 to 1.88), and AKI (8.6%; OR 1.52; 95% CI 1.36 to 1.70). Results were generally
homogenous in prespecified subgroups and for the other outcomes. In conclusion, 1
in 4 AMI survivors had either acute or chronic renal failure. The presence of any
form of renal failure was associated with a substantially increased risk of 6-month
HF hospitalizations and associated mortality with the highest risk associated with
AKI on CKD.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Long-term impact of chronic kidney disease in patients With ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: the HORIZONS-AMI (harmonizing outcomes with revascularization and stents in acute myocardial infarction) trial.JACC Cardiovasc Interv. 2011; 4: 1011-1019
- Renal failure and acute myocardial infarction: clinical characteristics in patients with advanced chronic kidney disease, dialysis, and without chronic kidney disease. A collaborative project of The United States Renal Data System/National Institutes of Health and the National registry of myocardial infarction.Am Heart J. 2012; 163: 399-406
- Acute kidney injury among older patients undergoing coronary angiography for acute myocardial infarction: the SILVER-AMI study.Am J Med. 2019; 132: e817-e826
- Short-term outcomes of acute myocardial infarction in patients with acute kidney injury: a report from the national cardiovascular data registry.Circulation. 2012; 125: 497-504
- Association of acute kidney injury and chronic kidney disease with processes of care and long-term outcomes in patients with acute myocardial infarction.Eur Heart J Qual Care Clin Outcomes. 2018; 4: 43-50
- Early development of acute kidney injury is an independent predictor of in-hospital mortality in patients with acute myocardial infarction.J Cardiol. 2017; 69: 79-83
- Long-term prognosis of acute kidney injury after acute myocardial infarction.Arch Intern Med. 2008; 168: 987-995
- Editor's Choice- What do small serum creatinine changes tell us about outcomes after acute myocardial infarction?.Eur Heart J Acute Cardiovasc Care. 2018; 7: 739-742
- Prognostic impact of in-hospital and postdischarge heart failure in patients with acute myocardial infarction: a nationwide analysis using data from the cardiovascular disease in Norway (CVDNOR) project.J Am Heart Assoc. 2017; 6e005277
- Improving care for patients with acute heart failure: before, during and after hospitalization.ESC Heart Fail. 2014; 1: 110-145
- Cardiovascular consequences of acute kidney injury.N Engl J Med. 2020; 382: 2238-2247
- Acute kidney injury and risk of heart failure and atherosclerotic events.Clin J Am Soc Nephrol. 2018; 13: 833-841
- AKI and long-term risk for cardiovascular events and mortality.J Am Soc Nephrol. 2017; 28: 377-387
- The impact of transient and persistent acute kidney injury on long-term outcomes after acute myocardial infarction.Kidney Int. 2009; 76: 900-906
NRD overview. Healthcare Cost and Utilization Project (HCUP). Agency for Healthcare Research and Quality. 2019. Updated October 2021. Available at: https://www.hcup-us.ahrq.gov/nrdoverview.jsp. Accessed on March 21, 2019.
- Cardiogenic shock during heart failure hospitalizations: age-, sex-, and race-stratified trends in incidence and outcomes.Am Heart J. 2019; 213: 18-29
- Sex differences in heart failure hospitalisation risk following acute myocardial infarction.Heart. 2021; 107: 1657-1663
- Assessing the fit of the model.in: Hosmer DW Lemeshow S Applied Logistic Regression. John Wiley & Sons, Chichester2005: 143-202
- Trends in the incidence of acute kidney injury in patients hospitalized with acute myocardial infarction.Arch Intern Med. 2012; 172: 246-253
- Predictors of acute kidney injury in patients admitted with ST-elevation myocardial infarction - results from the Bremen STEMI-Registry.Eur Heart J Acute Cardiovasc Care. 2018; 7: 710-722
- Incidence and impact of acute kidney injury in patients with acute coronary syndromes treated with coronary artery bypass grafting: insights from the harmonizing outcomes with revascularization and stents in acute myocardial infarction (HORIZONS-AMI) and acute catheterization and urgent intervention triage strategy (ACUITY) trials.Am Heart J. 2016; 171: 40-47
- Contrast-associated acute kidney injury.N Engl J Med. 2019; 380: 2146-2155
- FGF23 induces left ventricular hypertrophy.J Clin Invest. 2011; 121: 4393-4408
- Plasma FGF23 levels increase rapidly after acute kidney injury.Kidney Int. 2013; 84: 776-785
- Impact of chronic kidney disease on postinfarction inflammation, oxidative stress, and left ventricular remodeling.J Card Fail. 2008; 14: 831-838
- Prognostic significance of acute kidney injury after reperfused ST-elevation myocardial infarction: synergistic acceleration of renal dysfunction and left ventricular remodeling.J Card Fail. 2010; 16: 381-389
- Management and outcomes of renal disease and acute myocardial infarction.Am J Med. 2010; 123: 847-855
- Wald R. 30-day readmissions after an acute kidney injury hospitalization.Am J Med. 2017; 130 (163–172.e4)
- Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) Investigators. Associations Between acute kidney injury and cardiovascular and renal outcomes after coronary angiography.Circulation. 2011; 123: 409-416
- Association between AKI and long-term renal and cardiovascular outcomes in United States veterans.Clin J Am Soc Nephrol. 2014; 9: 448-456
- Myocardial Infarction Data Acquisition System (MIDAS 31) Study Group. Risk factors and trends in incidence of heart failure following acute myocardial infarction.Am J Cardiol. 2018; 122: 1-5
Article info
Publication history
Published online: December 07, 2021
Received in revised form:
October 15,
2021
Received:
June 1,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
