In-Hospital Incidence of Acute Kidney Injury Among Patients of Acute Coronary Syndrome Who Have Transient Hypotension in Catheterization Laboratory

Abstract

Objective: To determine in-hospital incidence of acute kidney injury among patients of acute coronary syndrome who have transient hypotension in catheterization laboratory.

Methodology: A prospective hospital-based study was conducted at National Institute of Cardiovascular Disease (NICVD), Karachi from October 2022 to March, 2023. All adult patients admitted with acute coronary syndrome and underwent percutaneous coronary intervention within 72 hours of admission and experienced transient hypotension during procedure, normal renal function before procedure, age between 18 years to 75 years, and both males and females were included in this study. Baseline and clinical data were collected, and all statistical tests were conducted with a level of significance (p-value) of <0.05 using SPSS Version 22.0.

Results: The total cohort size consisted of 290 patients. Prevalence of acute kidney injury was more common in patients with STEMI 57(19.6%) followed by NSTEMI 18(6.2%), and UA 8(2.7%) but there is an insignificant association among them, p = 0.71. On multivariate binominal analysis, males (OR = 2.49), rural residents (OR = 0.25), hypertensives (OR = 2.18), diabetics (OR = 9.37), hyperlipidemia (OR = 3.85), and patients with LVEF <50% (OR = 6.34) were more likely to develop acute kidney injury (p = <0.05).

Conclusion: In this study, majority of the patients experienced acute kidney injury and prevalence in our study is higher than previously conducted studies. Among all risk factors, LVEF <50%, type 2 diabetes mellitus, and hyperlipidemia were most prevalent risk factors of AKI.