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Previous studies about contrast-induced acute kidney injury (CI-AKI) reported incidences of CI-AKI ranged from 2% to 30% due to different populations and CI-AKI definitions, and mostly based on selective percutaneous coronary intervention (PCI) cases, the risk factors of CI-AKI after emergency PCI are still undefined. The aim of this study was to investigate and analyze the risk factors of CI-AKI in diabetic population undergoing emergency percutaneous coronary intervention(PCI).
A total of 862 consecutive patients with diabetes mellitus(DM) undergoing emergency PCI during January 2010 and December 2016 in our center were enrolled and divided into CI-AKI group and control group. Univariable and multivariable analyses were used to identify the risk factors of CI-AKI in patients with DM during emergency PCI. CI-AKI was defined as an increase in serum creatinine ≥25% or ≥44.2 μmol/L (0.5 mg/dl) from baseline within 48-72h after the procedure.
The incidence of CI-AKI in patients with DM undergoing emergency PCI was 29.7% (256/862). Logistic multivariable analysis showed that history of myocardial infarction (MI) (OR 1.812, 95%CI: 1.436–2.486, P=0.012), baseline serum creatinine(SCr)<45ml/min(OR 2.362, 95%CI: 1.918–2.628, P<0.001),left ventricular ejection fraction (LVEF) (OR 0.869, 95%CI: 0.814–1.024, P=0.015), estimated glomerular filtration rate (eGFR)(OR 0.867, 95%CI: 0.618–1.037, P<0.001), HbA1c (OR 1.659, 95%CI: 1.419–1.912, P=0.03), IABP use(OR 2.426, 95%CI: 2.110–2.728, P<0.001)and statin use (OR 0.850, 95%CI: 0.682–1.000, P=0.018) were independent predictors of CI-AKI in diabetic patients undergoing emergency PCI.
CI-AKI are frequent complication among patients with DM undergoing emergency PCI. History of MI, SCr<45ml/min, LVEF, HbA1c and eGFR level, IABP and statin use are associated with increased risk of CI-AKI.