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Acute kidney injury (AKI) is a frequent complication of acute myocardial infarction (AMI). Accumulating evidence suggests that inflammation plays a key role in AKI pathogenesis and progression. We explored the relationship between high-sensitivity C-reactive protein (hs-CRP), a marker of systemic

High-sensitivity C-reactive protein (hs-CRP) is the most used inflammatory marker in acute myocardial infarction (AMI) and its levels are associated with outcome. Diabetes mellitus (DM) is a frequent comorbidity in AMI and it is characterized by some degree of chronic inflammation. Thus, detection

Pericardial effusion (PE) is characterized by accumulation of fluid within the pericardium, resulting in heart compression. As B-type natriuretic peptide (BNP) is secreted by the ventricles in response to increased myocardial stretch, we hypothesized that PE and its resolution might influence BNP

ObjectivesThe aim of this research was to assess the incidence, clinical predictors, and outcome of contrast-induced nephropathy (CIN) after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI).BackgroundContrast-induced nephropathy is associated with significant morbidity and mortality after PCI. Patients undergoing primary PCI may be at higher risk of CIN because of hemodynamic instability and unfeasibility of adequate prophylaxis.MethodsIn 208 consecutive AMI patients undergoing primary PCI, we measured serum creatinine concentration (Cr) at baseline and each day for the following three days. Contrast-induced nephropathy was defined as a rise in Cr >0.5 mg/dl.ResultsOverall, CIN occurred in 40 (19%) patients. Of the 160 patients with baseline Cr clearance ≥60 ml/min, only 21 (13%) developed CIN, whereas it occurred in 19 (40%) of those with Cr clearance 75 years (odds ratio [OR] 5.28, 95% confidence interval [CI] 1.98 to 14.05; p = 0.0009), anterior infarction (OR 2.17, 95% CI 0.88 to 5.34; p = 0.09), time-to-reperfusion >6 h (OR 2.51, 95% CI 1.01 to 6.16; p = 0.04), contrast agent volume >300 ml (OR 2.80, 95% CI 1.17 to 6.68; p = 0.02) and use of intraaortic balloon (OR 15.51, 95% CI 4.65 to 51.64; p < 0.0001) were independent correlates of CIN. Patients developing CIN had longer hospital stay (13 ± 7 days vs. 8 ± 3 days; p < 0.001), more complicated clinical course, and significantly higher mortality rate (31% vs. 0.6%; p < 0.001).ConclusionsContrast-induced nephropathy frequently complicates primary PCI, even in patients with normal renal function. It is associated with higher in-hospital complication rate and mortality. Thus, preventive strategies are needed, particularly in high-risk patients.