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Acute Kidney Injury in Acute Coronary Syndrome

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https://www.readbyqxmd.com/read/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#1
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29627229/the-use-of-cell-cycle-arrest-biomarkers-in-the-early-detection-of-acute-kidney-injury-is-this-the-new-renal-troponin
#2
Luis M Ortega, Michael Hueng
Acute kidney injury (AKI) has a high prevalence in critical care patients. Early detection might prevent patients from developing chronic kidney disease and requirement for renal replacement therapy. If we compare AKI with acute coronary syndrome, in which an increase in cardiac troponin may trigger early diagnosis and therapeutic intervention, we could extrapolate a similar technique in patients with early AKI without changes in urinary frequency or serum creatinine. The objective is to identify biomarker-positive, creatinine-negative patients that would allow therapeutic interventions to be initiated before finding changes in serum creatinine, preventing kidney damage...
April 4, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29559842/advancis-score-predicts-acute-kidney-injury-after-percutaneous-coronary-intervention-for-acute-coronary-syndrome
#3
Pei-Chun Fan, Tien-Hsing Chen, Cheng-Chia Lee, Tsung-Yu Tsai, Yung-Chang Chen, Chih-Hsiang Chang
Acute kidney injury (AKI), a common and crucial complication of acute coronary syndrome (ACS) after receiving percutaneous coronary intervention (PCI), is associated with increased mortality and adverse outcomes. This study aimed to develop and validate a risk prediction model for incident AKI after PCI for ACS. We included 82,186 patients admitted for ACS and receiving PCI between 1997 and 2011 from the Taiwan National Health Insurance Research Database and randomly divided them into a training cohort (n = 57,630) and validation cohort (n = 24,656) for risk model development and validation, respectively...
2018: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29545982/cocaine-induced-type-a-aortic-dissection-extending-to-the-common-iliac-arteries
#4
Mohamed A Mohamed, Rohit Abraham, Tareq I Maraqa, Samir Elian
Aortic dissection is a rare and fatal complication of cocaine-induced hypertension. The injury mechanism is through shear stress that penetrates the intimal vessel layer, allowing blood flow to separate intimal and medial layers. Due to its scarcity and the paucity of related literature, our knowledge of this condition is limited. We present a rare case of a cocaine-induced aortic dissection, which extended continuously from the aortic root to the common iliacs, along with a literature review of similar cases...
January 12, 2018: Curēus
https://www.readbyqxmd.com/read/29519544/comparison-of-the-effect-of-dual-axis-rotational-coronary-angiography-versus-conventional-coronary-angiography-on-frequency-of-acute-kidney-injury-x-ray-exposure-time-and-quantity-of-contrast-medium-injected
#5
Luigi Di Serafino, Maurizio Turturo, Saverio Lanzone, Melissa Marano, Gabriella Scognamiglio, Bruno Trimarco, Plinio Cirillo, Giovanni Esposito, Carlo D'Agostino
Dual-axis rotational coronary angiography (DARCA) has already been shown to reduce both the amount of contrast medium and radiation exposure compared with conventional coronary angiography (CCA). However, a clinical benefit of such imaging modality has never been demonstrated. The aim of this study was to evaluate the efficacy of DARCA to prevent acute kidney injury (AKI) compared with CCA. Consecutive patients who underwent coronary angiography were enrolled to DARCA (n = 80) or CCA (n = 80). Patients presenting with ST-segment elevation myocardial infarction or previously underwent coronary artery bypass graft were excluded...
February 7, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29488059/age-modifies-the-risk-factor-profiles-for-acute-kidney-injury-among-recently-diagnosed-type-2-diabetic-patients-a-population-based-study
#6
Chia-Ter Chao, Jui Wang, Hon-Yen Wu, Jenq-Wen Huang, Kuo-Liong Chien
The incidence of acute kidney injury (AKI) rises with age and is associated with multiple risk factors. Here, we compared the risk factors for AKI between younger and older incident diabetic patients to examine the trends in risk alteration for individual factors across different age groups. Between 2007 and 2013, we selected all incident type 2 diabetic adults from the Taiwan National Health Insurance registry, stratified based on age: young (< 65 years), old (≥ 65 but < 75 years), and older-old (≥ 75 years)...
February 27, 2018: GeroScience
https://www.readbyqxmd.com/read/29463106/association-of-preprocedural-hyperglycemia-with-contrast-induced-acute-kidney-injury-and-poor-outcomes-after-emergency-percutaneous-coronary-intervention
#7
Kai-Yang Lin, Xiu-Ling Shang, Yan-Song Guo, Peng-Li Zhu, Zhi-Yong Wu, Hui Jiang, Jing-Ming Ruan, Wei-Ping Zheng, Zhe-Bin You, Chun-Jin Lin
We investigated whether preprocedural hyperglycemia was associated with contrast-induced acute kidney injury (CI-AKI) and long-term outcomes in patients with acute coronary syndrome (ACS) who underwent emergency percutaneous coronary intervention (PCI). Patients (n = 558) with ACS who underwent emergency PCI were consecutively enrolled. Preprocedural hyperglycemia was defined as glucose levels >198 mg/dL (11 mmol/L). The primary outcome was CI-AKI (≥0.3 mg/dL absolute or ≥50% relative serum creatinine increase 48 hours after contrast medium exposure)...
January 1, 2018: Angiology
https://www.readbyqxmd.com/read/29456049/six-month-outcomes-after-high-risk-coronary-artery-bypass-graft-surgery-and-preoperative-intra-aortic-balloon-counterpulsation-use-an-inception-cohort-study
#8
Edward Litton, Frances Bass, Anthony Delaney, Graham Hillis, Silvana Marasco, Shay McGuinness, Paul S Myles, Christopher M Reid, Julian A Smith
OBJECTIVE: To inform the design of a pivotal randomized controlled trial of prophylactic intra-aortic balloon counterpulsation (IABC) in patients undergoing coronary artery bypass graft (CABG) at high risk of postoperative low cardiac output syndrome (LCOS). DESIGN: Inception cohort study. SETTING: A total of 13 established cardiac centers in Australia, Canada, New Zealand, and the United Kingdom. PARTICIPANTS: Adult patients were eligible for inclusion if they were listed for CABG surgery and had 2 or more LCOS risk factors (low ejection fraction, severe left main coronary artery disease, redo sternotomy, unstable angina)...
January 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29455574/immune-responsive-resolvin-d1-programs-myocardial-infarction-induced-cardiorenal-syndrome-in-heart-failure
#9
Ganesh V Halade, Vasundhara Kain, Charles N Serhan
Resolvins are innate, immune responsive, bioactive mediators generated after myocardial infarction (MI) to resolve inflammation. The MI-induced bidirectional interaction between progressive left ventricle (LV) remodeling and kidney dysfunction is known to advance cardiorenal syndrome (CRS). Whether resolvins limit MI-induced cardiorenal inflammation is unclear. Thus, to define the role of exogenous resolvin D (RvD)-1 in post-MI CRS, we subjected 8-12-wk-old male C57BL/6 mice to coronary artery ligation. RvD1 was injected 3 h after MI...
February 13, 2018: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/29397881/incidence-predictors-and-impact-on-six-month-mortality-of-three-different-definitions-of-contrast-induced-acute-kidney-injury-after-coronary-angiography
#10
Benoit Guillon, Fiona Ecarnot, Charles Marcucci, Didier Ducloux, Marion Chatot, Marc Badoz, Benjamin Bonnet, Romain Chopard, Pierre Frey, Nicolas Meneveau, François Schiele
We assessed incidence, predictors, and impact on 6-month mortality of contrast-induced acute kidney injury (CI-AKI) after coronary angiography with or without percutaneous coronary intervention in patients with acute coronary syndrome (ACS), according to 3 different CI-AKI definitions. Serum creatinine (sCr) was assessed at baseline and 48 to 72 hours after procedure to classify patients into 3 CI-AKI groups: Group 1: increase in sCR ≥25% over baseline but absolute increase <0.5 mg/dl; Group 2: absolute increase ≥0...
January 9, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29339356/kidney-biomarkers-and-decline-in-egfr-in-patients-with-type-2-diabetes
#11
Katherine G Garlo, William B White, George L Bakris, Faiez Zannad, Craig A Wilson, Stuart Kupfer, Muthiah Vaduganathan, David A Morrow, Christopher P Cannon, David M Charytan
BACKGROUND AND OBJECTIVES: Biomarkers may improve identification of individuals at risk of eGFR decline who may benefit from intervention or dialysis planning. However, available biomarkers remain incompletely validated for risk stratification and prediction modeling. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined serum cystatin C, urinary kidney injury molecule-1 (uKIM-1), and urinary neutrophil gelatinase-associated lipocalin (UNGAL) in 5367 individuals with type 2 diabetes mellitus and recent acute coronary syndromes enrolled in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) trial...
March 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29181161/effects-of-hydration-combined-with-shenfu-injection-on-contrast-induced-acute-kidney-injury-in-acute-coronary-syndrome-patients-undergoing-percutaneous-coronary-intervention
#12
Zhen Guo, Dandan Niu, Yaren Yu, Di Zhen, Wenhua Li
The aim of the present study was to evaluate the efficacy and safety of the Shenfu injection (SFI) in the prevention of contrast-induced acute kidney injury (CI-AKI) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). A single-center prospective and randomized controlled trial was performed and 148 ACS patients undergoing PCI were divided randomly into control (n=74; receiving only 0.9% sodium chloride solution for routine hydration) and intervention (n=74; based upon routine hydration and receiving SFI) groups...
November 2017: Biomedical Reports
https://www.readbyqxmd.com/read/29165381/factors-associated-with-the-need-for-and-the-impact-of-extracorporeal-membrane-oxygenation-in-children-with-congenital-heart-disease-during-admissions-for-cardiac-surgery
#13
Salvatore Aiello, Rohit S Loomba
INTRODUCTION: This study aimed to determine factors associated with the need for extracorporeal membrane oxygenation (ECMO) in children with congenital heart disease (CHD) during admission for cardiac surgery (CS). A secondary aim was to determine how ECMO impacted length, cost, and mortality of the admission. METHODS: Data from the Kids' Inpatient Database (KIDS) were utilized. Admissions with CHD under 18 years of age with cardiac surgery were included. Need for ECMO in these admissions was then identified...
November 22, 2017: Children
https://www.readbyqxmd.com/read/29100589/effect-of-access-site-choice-on-acute-kidney-injury-after-percutaneous-coronary-intervention
#14
Maitri S Pancholy, Kimberly Skelding, Thomas Scott, James Blankenship, Samir B Pancholy
Acute kidney injury (AKI) after percutaneous coronary intervention (PCI) is associated with worse outcomes. Consecutive patients undergoing PCI between 2005 and 2013 were retrospectively analyzed. Patients undergoing PCI using transfemoral access (TFA) were categorized as the TFA Group, and those using transradial access (TRA) were categorized as the TRA Group. Post-PCI AKI was defined as an increase in serum creatinine >0.5 mg/dl or >25% increase from baseline 48 to 72 hours after the procedure. Independent predictors of post-PCI AKI were identified using inverse probability weighted multivariable analysis...
December 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29040268/benefit-and-harm-of-intensive-blood-pressure-treatment-derivation-and-validation-of-risk-models-using-data-from-the-sprint-and-accord-trials
#15
Sanjay Basu, Jeremy B Sussman, Joseph Rigdon, Lauren Steimle, Brian T Denton, Rodney A Hayward
BACKGROUND: Intensive blood pressure (BP) treatment can avert cardiovascular disease (CVD) events but can cause some serious adverse events. We sought to develop and validate risk models for predicting absolute risk difference (increased risk or decreased risk) for CVD events and serious adverse events from intensive BP therapy. A secondary aim was to test if the statistical method of elastic net regularization would improve the estimation of risk models for predicting absolute risk difference, as compared to a traditional backwards variable selection approach...
October 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29033507/syntax-score-of-infarct-related-artery-other-than-the-number-of-coronary-balloon-inflations-and-deflations-as-an-independent-predictor-of-contrast-induced-acute-kidney-injury-in-patients-with-st-segment-elevation-myocardial-infarction
#16
Cheng-Wei Liu, Pen-Chih Liao, Kuo-Chin Chen, Jung-Cheng Hsu, Chung-Ming Tu, Yen-Wen Wu, Ai-Hsien Li, Shin-Rong Ke, Jiunn-Lee Lin
BACKGROUND: Although remote ischemic post-conditioning (RIPC) has been shown to prevent contrast-induced acute kidney injury (CIAKI) in patients with acute coronary syndrome, its efficacy in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. We examined the relationship among balloon inflations and deflations (BID) times, SYNTAX score of infarction-related artery (SI), periprocedural complications, and CIAKI in STEMI patients undergoing primary percutaneous coronary intervention (pPCI)...
July 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29027072/outcomes-of-acute-kidney-injury-in-a-nephrology-ward
#17
Ana R Fernandes, Márcio S R Viegas, Elsa Q Soares, Sofia S Coelho, Patricia Valério, José C Barreto, José M Vinhas
Acute kidney injury (AKI) is a global problem which predicts immediate and long-term adverse outcomes. We evaluated the AKI progression to end-stage renal disease, as well as the mortality associated with AKI and the in-hospital readmission rate because of a cardiovascular event in AKI patients admitted in a nephrology ward. A 5-year retrospective study was set in a nephrology department, with a follow-up period of up to 8 years. In a total of 191 patients, mean age was 73.83 ± 12.49 years, and 137 (71...
December 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29026353/association-of-body-mass-index-and-postoperative-acute-kidney-injury-in-patients-undergoing-laparoscopic-surgery
#18
Maged Y Argalious, Natalya Makarova, Alexander Leone, Jacek Cywinski, Ehab Farag
BACKGROUND: Whether the deleterious effects of carbon dioxide pneumoperitoneum on the kidneys are exacerbated in the obese population remains unknown. We hypothesized that increased body mass index (BMI) is associated with an increased incidence of postoperative acute kidney injury (AKI) in patients undergoing noncardiac laparoscopic surgery. METHODS: Following institutional review board approval, we analyzed data on 8,543 adult patients with American Society of Anesthesiologists physical status scores of I-IV who had inpatient noncardiac laparoscopic surgery from 2005-2014...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28985328/blood-pressure-variability-predicts-adverse-events-and-cardiovascular-outcomes-in-chronic-kidney-disease-a-post-hoc-analysis-of-the-sprint-trial
#19
Kenechukwu Mezue, Abhinav Goyal, Gregg S Pressman, Jay C Horrow, Janani Rangaswami
BACKGROUND: Visit-to-visit blood pressure variability has been associated with adverse cardiovascular outcomes. Using the SPRINT trial data set, we explored the relationship between blood pressure variability, cardiovascular outcomes, and hypoperfusion-related adverse events of antihypertensive therapy in patients with chronic kidney disease (CKD) enrolled in the study. METHODS: The analyses included patients with CKD randomized in SPRINT who reached the target systolic blood pressure for their respective groups (intensive <120 mm Hg; standard <140 mm Hg)...
December 8, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28939956/radial-access-protects-from-contrast-media-induced-nephropathy-after-cardiac-catheterization-procedures
#20
Thorsten Feldkamp, Maya Luedemann, Martina E Spehlmann, Sandra Freitag-Wolf, Julia Gaensbacher, Kevin Schulte, Amer Bajrovic, Dieter Hinzmann, Hans-Joerg Hippe, Ulrich Kunzendorf, Norbert Frey, Mark Luedde
OBJECTIVES: To assess, whether cardiac catheterization via radial access prevents contrast-induced nephropathy. BACKGROUND: Contrast-induced nephropathy (CIN) is a major clinical problem which accounts for more than 10% of acute kidney injury cases in hospitalized patients. Protective measures such as the infusion of isotonic saline solution or acetylcysteine have not consistently been proven to prevent acute kidney injury (AKI). However, there is growing evidence that radial access for coronary angiography and coronary intervention is associated with a lower incidence of AKI compared to femoral access...
September 22, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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