Increase observed in elderly patients with heart attack receiving stents
FRIDAY, Nov. 1 (HealthDay News) -- Over the last decade there has been an increase in the incidence of acute kidney injury (AKI), but a decrease in the incidence of AKI requiring dialysis, among elderly patients hospitalized with a heart attack who have undergone percutaneous coronary intervention, according to a study published in the Nov. 1 issue of The American Journal of Cardiology.
Sahil Khera, M.D., from the New York Medical College in Valhalla, and colleagues analyzed data on 2,225,707 patients 75 years and older hospitalized with acute myocardial infarction from 2002 to 2010, where 233,508 (10.5 percent) underwent early percutaneous coronary intervention.
The researchers found that 21,961 patients (9.4 percent) developed AKI and 1,257 patients (0.54 percent) developed AKI requiring dialysis. Compared with 2002 and after adjusting for various factors, in 2010 the likelihood of AKI increased (odds ratio, 1.87), the likelihood of AKI requiring dialysis decreased (odds ratio, 0.20), and the likelihood of in-hospital mortality decreased (odds ratio, 0.74).
"In conclusion, among hospitalized adults ≥75 years of age, from 2002 to 2010, there was an increase in AKI, but there was paradoxical decrease in AKI requiring dialysis and in-hospital mortality, potentially reflecting increased health care provider awareness resulting in early recognition and implementation of renal-protective strategies and diagnosis-related group creep," Khera and colleagues write.
Abstract (http://www.ajconline.org/article/S0002-9149(13)01426-4/abstract )Full Text (subscription or payment may be required) (http://www.ajconline.org/article/S0002-9149(13)01426-4/fulltext )