Background: Cardiovascular disease remains a leading cause of global morbidity and mortality and often initially presents as Acute Coronary Syndrome (ACS), with renal dysfunction such as Acute Kidney Injury (AKI) frequently occurring and contributing to poorer outcomes.
Aim: This study aimed to compare in-hospital and six-month clinical outcomes among ST-Elevation Myocardial Infarction (STEMI) patients undergoing Percutaneous Coronary Intervention (PCI) with and without AKI.
Methods: A retrospective cohort study was conducted using the 2022 ACS Registry data. A total of 140 STEMI patients treated with PCI were included. Patients were divided into two groups based on the presence or absence of AKI. Clinical outcomes assessed included length of stay (LOS), incidence of heart failure, and Major Adverse Cardiovascular and Cerebrovascular Events (MACCE) during hospitalization and six months after discharge.
Results: A total of 140 patients were included (AKI, n = 35; non-AKI, n = 105). The AKI group was older and had lower systolic and diastolic blood pressures, with higher TIMI risk scores (all p < 0.05), while the sex distribution was similar. Random blood glucose and left ventricular ejection fraction were numerically worse but not statistically significant. Urea, creatinine, and potassium levels were significantly elevated in the AKI group (all p < 0.001). Length of stay was longer in the AKI group (8.77 ± 3.86 vs. 6.25 ± 2.53 days, p < 0.001), with more patients hospitalized for more than 8 days (53.3% vs. 24.2%, p = 0.003). In-hospital MACCE was not significantly different (34.3% vs. 45.7%, p = 0.237). However, at 6 months, the incidence of MACCE was significantly higher in the AKI group (25.8% vs. 4.2%, p < 0.001). Overall MACCE rates were comparable. At 6 months, heart failure occurred more frequently in AKI patients (22.6% vs. 3.2%, p = 0.001), while reinfarction and mortality rates were similar between the groups.
Conclusions: AKI in STEMI patients undergoing PCI is associated with worse clinical outcomes. Early detection and intervention are essential to improve prognosis.
