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Acute Kidney Injury in Acute Coronary Syndrome

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https://www.readbyqxmd.com/read/28528767/acute-kidney-injury-after-radial-or-femoral-access-for-invasive-acute-coronary-syndrome-management-aki-matrix
#1
Giuseppe Andò, Bernardo Cortese, Filippo Russo, Martina Rothenbühler, Enrico Frigoli, Giuseppe Gargiulo, Carlo Briguori, Pascal Vranckx, Sergio Leonardi, Vincenzo Guiducci, Flavia Belloni, Fabio Ferrari, Jose Maria de la Torre Hernandez, Salvatore Curello, Francesco Liistro, Andrea Perkan, Stefano De Servi, Gavino Casu, Antonio Dellavalle, Dionigi Fischetti, Antonio Micari, Bruno Loi, Fabio Mangiacapra, Nunzio Russo, Fabio Tarantino, Francesco Saia, Dik Heg, Stephan Windecker, Peter Jüni, Marco Valgimigli
BACKGROUND: It remains unclear whether radial access (RA), compared with femoral access (FA), mitigates the risk of acute kidney injury (AKI). OBJECTIVES: The authors assessed the incidence of AKI in patients with acute coronary syndrome (ACS) enrolled in the MATRIX-Access (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial. METHODS: Among 8,404 patients, 194 (2.3%) were excluded due to missing creatinine values, no or an incomplete coronary angiogram, or previous dialysis...
May 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28427574/acute-noncardiovascular-illness-in-the-cardiac-intensive-care-unit
#2
Eric M Holland, Travis J Moss
BACKGROUND: Fifty years after the inception of the cardiac intensive care unit (CICU), noncardiovascular illnesses have become more prevalent and may contribute to morbidity and mortality. OBJECTIVES: The authors performed multivariate statistical analyses to determine the association of acute noncardiovascular illnesses with outcomes, including length of stay (LOS), mortality, and hospital readmission. METHODS: We studied 1,042 admissions between October 12, 2013 and November 28, 2014 to the CICU at the University of Virginia Health System, a tertiary-care academic medical center...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28384188/baroreflex-sensitivity-and-outcomes-following-coronary-surgery
#3
Marco Ranucci, Alberto Porta, Vlasta Bari, Valeria Pistuddi, Maria Teresa La Rovere
Postoperative atrial fibrillation, acute kidney dysfunction and low cardiac output following coronary surgery are associated with morbidity and mortality. The purpose of this study is to determine if the preoperative autonomic control is a determinant of these postoperative complications. This is a prospective cohort study on 150 adult patients undergoing surgical coronary revascularization with cardiopulmonary bypass. The patients received an autonomic control assessment after the induction of anesthesia. Baroreflex sensitivity was computed by spectral analysis and expressed as BRSαHF and BRSαLF for measure respectively in the high and low frequency domains...
2017: PloS One
https://www.readbyqxmd.com/read/28329287/outcome-after-procedures-for-retained-blood-syndrome-in-coronary-surgery
#4
Tuomas Tauriainen, Eeva-Maija Kinnunen, Joni Koski-Vähälä, Matti-Aleksi Mosorin, Juhani Airaksinen, Fausto Biancari
OBJECTIVES: Incomplete drainage of blood from around the heart and lungs can lead to retained blood syndrome (RBS) after cardiac surgery. The aim of this study was to assess the incidence of and the outcome after procedures for RBS in patients undergoing isolated coronary artery bypass grafting (CABG). METHODS: A total of 2764 consecutive patients who underwent isolated CABG from 2006 to 2013 were investigated retrospectively. Patients undergoing any procedure for RBS were compared with patients who did not undergo any procedure for RBS...
June 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28290859/-prognostic-significance-of-erythropoietin-in-patients-with-acute-coronary-syndrome
#5
M V Menzorov, A M Shutov, N V Larionova, A A Strakhov, D V Serova
AIM: to investigate the prognostic role of erythropoietin (EPO) in patients with acute coronary syndrome (ACS). MATERIAL AND METHODS: Eighty-four patients (46 men, 38 women, mean age 63+/-11 years) with ACS were studied. Twenty-one patients had ST-elevation myocardial infarction (STEMI), 12 - non-ST-elevation myocardial infarction, 51 - unstable angina (UA). Ten patients with STEMI received thrombolytic therapy. Coronary angiography during hospitalization was criterion for exclusion from the study...
September 2016: Kardiologiia
https://www.readbyqxmd.com/read/28032431/degree-of-dyspnoea-in-patients-with-non-st-elevation-acute-coronary-syndrome-a-report-from-japanese-multicenter-registry
#6
Yasuyuki Shiraishi, Shun Kohsaka, Ikuko Ueda, Taku Inohara, Mitsuaki Sawano, Yohei Numasawa, Kentaro Hayashida, Yuichiro Maekawa, Yukihiko Momiyama, Keiichi Fukuda
BACKGROUND: Degree of dyspnoea is almost universally evaluated in the patients presenting with acute coronary syndrome (ACS), but its clinical implications has not been thoroughly investigated. We aimed to describe the relationship between the severity of dyspnoea and in-hospital outcomes in patients with non-ST elevation ACS (NSTE-ACS) complicated with acute heart failure (AHF). METHODS: Between 2009 and 2014, 3287 consecutive patients with NSTE-ACS were enrolled in the Japanese prospective multicenter PCI registry...
December 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28024656/validation-of-bleeding-classifications-in-coronary-artery-bypass-grafting
#7
Debora Brascia, Daniel Reichart, Francesco Onorati, Andrea Perrotti, Vito G Ruggieri, Karl Bounader, Jean Philippe Verhoye, Giuseppe Santarpino, Theodor Fischlein, Daniele Maselli, Carmelo Dominici, Giovanni Mariscalco, Riccardo Gherli, Antonino S Rubino, Marisa De Feo, Ciro Bancone, Giuseppe Gatti, Francesco Santini, Magnus Dalén, Matteo Saccocci, Giuseppe Faggian, Tuomas Tauriainen, Eeva-Maija Kinnunen, Francesco Nicolini, Tiziano Gherli, Stefano Rosato, Fausto Biancari
Perioperative bleeding is a determinant of poor outcome in patients undergoing coronary artery bypass grafting (CABG), but there is a lack of adequate stratification of its severity. The ability of the European registry of Coronary Artery Bypass Grafting (E-CABG), Universal Definition of Perioperative Bleeding (UDPB), Study of Platelet Inhibition and Patient Outcomes (PLATO), Clopidogrel and Aspirin Optimal Dose Usage to Reduce Recurrent Events-Seventh Organization to Assess Strategies in Ischemic Syndromes (CURRENT-OASIS 7), Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q Wave Coronary Events (ESSENCE), and SafeTy and Efficacy of Enoxaparin in Percutaneous coronary intervention patients, an internationaL randomized Evaluation (STEEPLE) bleeding classifications to predict early mortality, stroke, acute kidney injury (AKI) stage 3, and deep sternal wound infection/mediastinitis was investigated in 3,730 patients from the prospective, multicentre E-CABG registry...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27990707/acute-kidney-injury-and-mortality-prognosis-in-acute-coronary-syndrome-patients-a-meta-analysis
#8
John W Pickering, Isabella Rh Blunt, Martin P Than
AIM: To provide a robust estimates of mortality risk in acute coronary syndrome (ACS) associated acute kidney injury (AKI) to inform clinical practice and policy. METHODS: A meta-analysis of cohort studies evaluating outcomes of ACS and which reported AKI and AKI associated mortality. Studies were excluded if they incorporated patients not admitted through the emergency department (i.e. for elective procedures), were limited to cardiogenic shock or cardiac arrest, or relied on registry data for outcomes without further adjudication...
December 19, 2016: Nephrology
https://www.readbyqxmd.com/read/27969724/tct-376-the-relationship-between-continuous-deterioration-of-renal-function-in-contrast-induced-acute-kidney-injury-and-long-term-outcome-among-patients-with-acute-coronary-syndrome-multicenter-study
#9
Naohiko Nemoto, Hitoshi Anzai, Nobuyuki Kobayashi, Masato Nakamura
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27907067/incidence-mortality-and-positive-predictive-value-of-type-1-cardiorenal-syndrome-in-acute-coronary-syndrome
#10
Raquel Pimienta González, Patricia Couto Comba, Marcos Rodríguez Esteban, José Juan Alemán Sánchez, Julio Hernández Afonso, María Del Cristo Rodríguez Pérez, Itahisa Marcelino Rodríguez, Buenaventura Brito Díaz, Roberto Elosua, Antonio Cabrera de León
OBJECTIVES: To determine whether the risk of cardiovascular mortality associated with cardiorenal syndrome subtype 1 (CRS1) in patients who were hospitalized for acute coronary syndrome (ACS) was greater than the expected risk based on the sum of its components, to estimate the predictive value of CRS1, and to determine whether the severity of CRS1 worsens the prognosis. METHODS: Follow-up study of 1912 incident cases of ACS for 1 year after discharge. Cox regression models were estimated with time to event (in-hospital death, and readmission or death during the first year after discharge) as the dependent variable...
2016: PloS One
https://www.readbyqxmd.com/read/27863290/cardiorenal-acute-kidney-injury-epidemiology-presentation-causes-pathophysiology-and-treatment
#11
REVIEW
Luca Di Lullo, Antonio Bellasi, Domenico Russo, Mario Cozzolino, Claudio Ronco
Cardiovascular disease and major cardiovascular events represent main cause of death in both acute and chronic kidney disease patients. Kidney and heart failure are common and frequently co-exist; this organ - organ interaction, also called organ cross-talk led to well-known definition of cardiorenal syndrome (CRS). Here we'll describe cardiovascular involvement in patients with acute kidney injury (AKI). Also known as type-3 CRS or acute reno-cardiac CRS, it occurs when AKI contributes and/or precipitates development of acute cardiac injury...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27760527/outcome-of-cardiac-surgery-in-patients-with-low-preoperative-ejection-fraction
#12
Marina Pieri, Alessandro Belletti, Fabrizio Monaco, Antonio Pisano, Mario Musu, Veronica Dalessandro, Giacomo Monti, Gabriele Finco, Alberto Zangrillo, Giovanni Landoni
BACKGROUND: In patients undergoing cardiac surgery, a reduced preoperative left ventricular ejection fraction (LVEF) is common and is associated with a worse outcome. Available outcome data for these patients address specific surgical procedures, mainly coronary artery bypass graft (CABG). Aim of our study was to investigate perioperative outcome of surgery on patients with low pre-operative LVEF undergoing a broad range of cardiac surgical procedures. METHODS: Data from patients with pre-operative LVEF ≤40 % undergoing cardiac surgery at a university hospital were reviewed and analyzed...
October 18, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27754188/sp-05-1-should-the-target-for-blood-pressure-reduction-be-lower-in-adults-with-hypertension-and-a-history-of-cardiovascular-disease
#13
Paul Whelton
BACKGROUND: Choice of the optimal target for blood pressure (BP) reduction during treatment of patients with hypertension, including those with underlying co-morbid conditions, is an important challenge in clinical practice. The Systolic Blood Pressure Intervention Trial (SPRINT) was designed to provide guidance in selection of a Systolic BP target during treatment of hypertension. METHODS: Adults ≥50 years old with hypertension and at least one additional risk factor for cardiovascular disease (CVD), but excluding persons with diabetes mellitus, prior stroke, or advanced chronic kidney disease (CKD) were randomly assigned to intensive therapy (intensive), targeting a systolic BP (SBP) <120 mmHg, or standard therapy (standard), targeting a SBP <140 mmHg...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27652368/rehospitalization-for-heart-failure-in-the-elderly
#14
Ehimwenma J Ogbemudia, John Asekhame
OBJECTIVES: To determine the burden of preventable rehospitalization for decompensated heart failure in the elderly.  METHODS: This was a retrospective study performed in a Nigerian University Teaching Hospital,.   Demographic variables, etiology, and participants of heart failure were retrieved from data of elderly patients with heart failure admitted between January 2014 and December 2015. The participants were classified and described as either preventable, or unpreventable to determine whether the hospitalizations were preventable or not...
October 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27643145/sp-05-1-should-the-target-for-blood-pressure-reduction-be-lower-in-adults-with-hypertension-and-a-history-of-cardiovascular-disease
#15
Paul Whelton
BACKGROUND: Choice of the optimal target for blood pressure (BP) reduction during treatment of patients with hypertension, including those with underlying co-morbid conditions, is an important challenge in clinical practice. The Systolic Blood Pressure Intervention Trial (SPRINT) was designed to provide guidance in selection of a Systolic BP target during treatment of hypertension. METHODS: Adults ≥50 years old with hypertension and at least one additional risk factor for cardiovascular disease (CVD), but excluding persons with diabetes mellitus, prior stroke, or advanced chronic kidney disease (CKD) were randomly assigned to intensive therapy (intensive), targeting a systolic BP (SBP) <120 mmHg, or standard therapy (standard), targeting a SBP <140 mmHg...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27582110/blood-transfusion-and-the-risk-of-acute-kidney-injury-among-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention
#16
Wassef Karrowni, Amit Navin Vora, David Dai, Daniel Wojdyla, Habib Dakik, Sunil V Rao
BACKGROUND: Acute kidney injury (AKI) complicating percutaneous coronary intervention (PCI) is associated with adverse clinical outcomes. To date, no studies have evaluated the association of blood transfusion with AKI in patients undergoing PCI. METHODS AND RESULTS: We used a retrospective cohort study of all patients with acute coronary syndrome undergoing PCI from CathPCI Registry (n=1 756 864). The primary outcome was AKI defined as the rise in serum creatinine post procedure ≥0...
September 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27573032/optical-coherence-tomography-to-optimize-results-of-percutaneous-coronary-intervention-in-patients-with-non-st-elevation-acute-coronary-syndrome-results-of-the-multicenter-randomized-doctors-study-does-optical-coherence-tomography-optimize-results-of-stenting
#17
RANDOMIZED CONTROLLED TRIAL
Nicolas Meneveau, Geraud Souteyrand, Pascal Motreff, Christophe Caussin, Nicolas Amabile, Patrick Ohlmann, Olivier Morel, Yoann Lefrançois, Vincent Descotes-Genon, Johanne Silvain, Nassim Braik, Romain Chopard, Marion Chatot, Fiona Ecarnot, Hélène Tauzin, Eric Van Belle, Loïc Belle, François Schiele
BACKGROUND: No randomized study has investigated the value of optical coherence tomography (OCT) in optimizing the results of percutaneous coronary intervention (PCI) for non-ST-segment elevation acute coronary syndromes. METHODS: We conducted a multicenter, randomized study involving 240 patients with non-ST-segment elevation acute coronary syndromes to compare OCT-guided PCI (use of OCT pre- and post-PCI; OCT-guided group) to fluoroscopy-guided PCI (angiography-guided group)...
September 27, 2016: Circulation
https://www.readbyqxmd.com/read/27550512/echocardiographic-correlates-of-left-ventricular-filling-pressures-and-acute-cardio-renal-syndrome-in-st-segment-elevation-myocardial-infarction-patients
#18
Nir Flint, Natalia Kaufman, Amir Gal-Oz, Gilad Margolis, Yan Topilsky, Gad Keren, Yacov Shacham
OBJECTIVE: Increased transmitral flow velocity (E) to the early mitral annulus velocity (e') ratio (E/e'), signifying increased cardiac filling pressure, was previously found to be associated with deterioration of renal function in patients with congestive heart failure. No study, however, included patients with acute myocardial ischemia. We hypothesized that elevated E/e' ratio would be associated with an increased risk of acute kidney injury (AKI) in ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI)...
February 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/27502846/albuminuria-and-cardiovascular-events-in-patients-with-acute-coronary-syndromes-results-from-the-tracer-trial
#19
Axel Åkerblom, Robert M Clare, Yuliya Lokhnygina, Lars Wallentin, Claes Held, Frans Van de Werf, David J Moliterno, Uptal D Patel, Sergio Leonardi, Paul W Armstrong, Robert A Harrington, Harvey D White, Philip E Aylward, Kenneth W Mahaffey, Pierluigi Tricoci
BACKGROUND: Albuminuria is associated with cardiovascular (CV) outcomes. We evaluated albuminuria, alone and in combination with estimated glomerular filtration rate (eGFR), as a predictor of mortality and CV morbidity in 12,944 patients with non-ST-segment elevation acute coronary syndromes. METHODS: Baseline serum creatinine and urinary dipsticks were obtained, with albuminuria stratified into no/trace albuminuria, microalbuminuria (≥30 but <300 mg/dL), or macroalbuminuria (≥300 mg/dL)...
August 2016: American Heart Journal
https://www.readbyqxmd.com/read/27491837/dynamic-predictive-scores-for-cardiac-surgery-associated-acute-kidney-injury
#20
Wuhua Jiang, Jie Teng, Jiarui Xu, Bo Shen, Yimei Wang, Yi Fang, Zhouping Zou, Jifu Jin, Yamin Zhuang, Lan Liu, Zhe Luo, Chunsheng Wang, Xiaoqiang Ding
BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common complication with a poor prognosis. In order to identify modifiable perioperative risk factors for AKI, which existing risk scores are insufficient to predict, a dynamic clinical risk score to allow clinicians to estimate the risk of CSA-AKI from preoperative to early postoperative periods is needed. METHODS AND RESULTS: A total of 7233 cardiac surgery patients in our institution from January 2010 to April 2013 were enrolled prospectively and distributed into 2 cohorts...
2016: Journal of the American Heart Association
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