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Acute Kidney Injury Increase Risk of Left Ventricular Remodeling: A Cohort of 1,573 Patients

Authors :
Qiang Li
Shanshan Shi
Liwei Liu
Ming Ying
Weihua Chen
Bo Wang
Huanqiang Li
Zhidong Huang
Yong Liu
Jiyan Chen
Jin Liu
Wenguang Lai
Shiqun Chen
Haozhang Huang
Liling Chen
Source :
Frontiers in Physiology, Frontiers in Physiology, Vol 12 (2021)
Publication Year :
2021
Publisher :
Frontiers Media SA, 2021.

Abstract

Background: Acute kidney injury (AKI) is a common complication after coronary angiography (CAG) and associated with heart failure (HF). Left ventricular (LV) remodeling is a vital process in the progression of HF. However, few studies investigate the relationship between AKI and LV remodeling.Methods: We included consecutive patients undergoing CAG from January 2007 to December 2018 at Guangdong Provincial People’s Hospital (NCT04407936). AKI was defined as an absolute increase in serum creatinine (Scr) of ≥ 0.3mg/dl or a ≥ 50% increase in Scr from baseline within the first 48–72 h after the procedure. LV remodeling was defined as: (1) an absolute decrease in left ventricular ejection fraction (LVEF) of ≥ 10% compared to baseline, or (2) a follow-up LVEF < 40%. Univariate and multivariate logistical regressions were used to assess the association between AKI and LV remodeling.Results: Of the 1,573 patients (62.2 ± 9.7 years, female 36.7%) included in the study, 231 (14.7%) had AKI. The incidence of LV remodeling was higher in patients with AKI than in those without AKI (24.7% vs. 14.5%). After adjusting for confounding, multivariate logistic regression showed that AKI was associated with a significantly higher risk of LV remodeling [adjusted odds ratio (aOR) 1.87; 95% CI, 1.30–2.66; p < 0.001]. In addition, LV remodeling patients had higher all-cause mortality compared to non-LV remodeling patients (9.7% vs. 19.1%).Conclusion: Our data suggested that AKI is present in up to 15% of patients after CAG and that nearly a quarter of AKI patients suffered LV remodeling and AKI patients have a two-fold risk of developing LV remodeling than non-AKI patients. Our findings suggest that more active measures be taken not only to prevent AKI patient developing into LV remodeling, but to prevent patients undergoing CAG from developing AKI.

Details

Language :
English
ISSN :
1664042X
Volume :
12
Database :
OpenAIRE
Journal :
Frontiers in Physiology
Accession number :
edsair.doi.dedup.....8ce4f2040bc4d93864f45b2a3d8fbc45
Full Text :
https://doi.org/10.3389/fphys.2021.744735