Volume : 9, Issue : 1, January - 2020

AKI in Post MI: A Killer in Disguise

Abhishek Kumar Verma, Kamlesh Taori, Hetal Boricha

Abstract :

Introduction: There has been a constant association of adverse clinical outcome in myocardial infarction (MI) patients with acute kidney injury (AKI). However, whether AKI contributes to an excess risk of cardiovascular events is still controversial, as very few studies are conducted in this context and less amount of knowledge regarding AKI’s short-term effects after its occurrence as a complication of AMI, so this study was performed. Aim: To find the incidence of AKI in post MI patients, study their clinical profile and outcome of AKI in post MI patients. Material and Method: Prospective observational study was undertaken in Saraswathi Medical College and Hospital, Bareilly including 100 patients admitted in the ICU, emergency and ward from 1stMay 2019 to 31stNov 2019. They were subjected to careful history taking and detailed clinical examination; routine investigations were done. The data was computed and was statistically analyzed. Results: Out of 100, 36 patients had AKI. Mean age of the patients with AKI was 50± 6.1years and those without AKI was 53±5.9 years. Out of 100, 44 had inferior wall MI, 36 had anterior wall MI and 20 had NSTEMI. Mean fasting blood glucose (mg/dL) in patients without AKI was 94.7±32 and in those with AKI was 145±40. Mean troponin I(ng/ml) was 2.4±3.4 in patients without AKI and 5.29±7.1in those with AKI which was found statistically significant (p value=0.015). Mean urea (mg/dL) and creatinine (mg/dL) was 33.9±11.9 and 0.74±0.11 respectively in patients without AKI and with AKI was 70±48.9 and 2±1.45 respectively. Patients with AKI after MI had a more number of complications like arrhythmia, heart failure, hypotension, LVEF (<30%), rupture (free wall or septum or papillary muscle) as compared to patients without AKI. Mortality in patients without AKI was 4 and in patients with AKI was 6 . Conclusion: High troponin I and older age are the most important risk factors for AKI in patients with acute MI. Post-MI complications and mortality in patients with AKI was more than that in patients without AKI. Careful monitoring of susceptible patients in ICU is recommended for early detection and management of AKI in patients with MI