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. 2015 Jun;5(3):191-8.
doi: 10.1159/000430472. Epub 2015 May 30.

Admission Glucose Levels and the Risk of Acute Kidney Injury in Nondiabetic ST Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

Yacov Shacham  1 , Amir Gal-Oz  2 , Eran Leshem-Rubinow  1 , Yaron Arbel  1 , Gad Keren  1 , Arie Roth  1 , Arie Steinvil  1
Affiliations

Admission Glucose Levels and the Risk of Acute Kidney Injury in Nondiabetic ST Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

Yacov Shacham et al. Cardiorenal Med. 2015 Jun.

Abstract

Background: Hyperglycemia upon admission is associated with an increased risk for acute kidney injury (AKI) in ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). However, the relation of this association to the absence of diabetes mellitus (DM) is less studied. We evaluated the effect of acute hyperglycemia levels on the risk of AKI among STEMI patients without DM who were all treated with primary PCI.

Methods: We retrospectively studied 1,065 nondiabetic STEMI patients undergoing primary PCI. Patients were stratified according to admission glucose levels into normal (<140 mg/dl), mild (140-200 mg/dl), and severe (>200 mg/dl) hyperglycemia groups. Medical records were reviewed for the occurrence of AKI.

Results: The mean age was 61 ± 13 years and 81% were males. Hyperglycemia upon hospital admission was present in 402 of 1,065 patients (38%). Patients with severe admission hyperglycemia had a significantly higher rate of AKI compared to patients with no or mild hyperglycemia (20 vs. 7 and 8%, respectively; p = 0.001) and had a significantly greater serum creatinine change throughout hospitalization (0.17 vs. 0.09 and 0.07 mg/dl, respectively; p = 0.04). In multivariate logistic regression, severe hyperglycemia emerged as an independent predictor of AKI (OR = 2.46, 95% CI 1.16-5.28; p = 0.018).

Conclusion: Severe admission hyperglycemia is an independent risk factor for the development of AKI among nondiabetic STEMI patients undergoing primary PCI.

Keywords: Acute kidney injury; Acute myocardial infarction; Diabetes mellitus; Hyperglycemia.

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Figures

Fig. 1
Fig. 1
Frequency of AKI among 1,065 nondiabetic STEMI patients undergoing primary PCI, according to admission glucose levels (p = 0.001). The OR for AKI development was 3.09 (95% CI 1.63-5.64; p = 0.001) when comparing patients with severe versus patients without hyperglycemia and 2.86 (95% CI 1.45-5.65; p = 0.004) for patients with severe versus patients with mild hyperglycemia.
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