{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,15]],"date-time":"2024-09-15T13:03:18Z","timestamp":1726405398171},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,2,1]],"date-time":"2015-02-01T00:00:00Z","timestamp":1422748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2015,5]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>The worsening of serum creatinine (sCr<\/jats:styled-content>) level is a frequent finding among ST<\/jats:styled-content>\u2010segment elevation MI<\/jats:styled-content> (STEMI<\/jats:styled-content>) patients undergoing primary percutaneous coronary intervention (PCI<\/jats:styled-content>), associated with adverse short\u2010term and long\u2010term outcomes. No information is present, however, regarding the incidence and prognostic implications associated with an improvement in sCr<\/jats:styled-content> levels throughout hospitalization, as compared with admission levels.<\/jats:p><\/jats:sec>Hypothesis<\/jats:title>Reversible renal impairment prior to PCI<\/jats:styled-content> is not associated with adverse outcomes.<\/jats:p><\/jats:sec>Methods<\/jats:title>We retrospectively studied 1260 STEMI<\/jats:styled-content> patients undergoing primary PCI<\/jats:styled-content>. The incidence of in\u2010hospital complications and long\u2010term mortality was compared between patients having stable, worsened (>0.3 mg\/dL<\/jats:styled-content> increase), or improved (>0.3 mg\/dL<\/jats:styled-content> decrease) sCr<\/jats:styled-content> levels throughout hospitalization.<\/jats:p><\/jats:sec>Results<\/jats:title>Overall, 127 patients (10%) had worsening in sCr<\/jats:styled-content> levels, whereas 44 (3.5%) had an improvement of sCr<\/jats:styled-content> compared with admission levels. Patients with worsening sCR<\/jats:styled-content> had more complications during hospitalization, higher 30\u2010day (13% vs 1%; P<\/jats:italic> < 0.001) and up to 5\u2010year all\u2010cause mortality (28% vs 5%; P<\/jats:italic> < 0.001) compared with those with stable sCR<\/jats:styled-content>. No significant difference was found regarding complications and mortality between patients having an improvement in sCr<\/jats:styled-content> and stable sCr<\/jats:styled-content>. Compared with patients with stable sCr<\/jats:styled-content>, the adjusted hazard ratio for all\u2010cause mortality in patients with worsened sCr<\/jats:styled-content> was 6.68 (95% confidence interval: 2.1\u201021.6, P<\/jats:italic> = 0.002).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In STEMI<\/jats:styled-content> patients undergoing primary PCI<\/jats:styled-content>, renal impairment prior to PCI<\/jats:styled-content> is a frequent finding. In contrast to post\u2010PCI sCr<\/jats:styled-content> worsening, this entity is not associated with adverse short\u2010term and long\u2010term outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22384","type":"journal-article","created":{"date-parts":[[2015,2,1]],"date-time":"2015-02-01T22:10:37Z","timestamp":1422828637000},"page":"274-279","source":"Crossref","is-referenced-by-count":9,"title":["Relation of In\u2010hospital Serum Creatinine Change Patterns and Outcomes Among ST<\/scp>\u2010Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention"],"prefix":"10.1002","volume":"38","author":[{"given":"Yacov","family":"Shacham","sequence":"first","affiliation":[{"name":"Department of Cardiology Tel\u2010Aviv University Tel\u2010Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eran","family":"Leshem\u2010Rubinow","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tel\u2010Aviv University 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