Impact of point-of-care pre-procedure creatinine and eGFR testing in patients with ST segment elevation myocardial infarction undergoing primary PCI: The pilot STATCREAT study

Karamasis, Grigoris V. and Hampton-Till, James and Al-Janabi, Firas and Mohdnazri, Shah and Parker, Michael and Ioannou, Adam and Jagathesan, Rohan and Kabir, Alagmir and Sayer, Jeremy W. and Robinson, Nicholas M. and Aggarwal, Rajesh K. and Clesham, Gerald J. and Gamma, Reto A. and Kelly, Paul A. and Tang, Kare H. and Davies, John R. and Keeble, Thomas R. (2017) Impact of point-of-care pre-procedure creatinine and eGFR testing in patients with ST segment elevation myocardial infarction undergoing primary PCI: The pilot STATCREAT study. International Journal of Cardiology, 240. pp. 8-13. ISSN 1874-1754

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Official URL: https://doi.org/10.1016/j.ijcard.2017.03.147

Abstract

Background: Contrast-induced acute kidney injury (CI-AKI) is a recognised complication during primary PCI that affects short and long term prognosis. The aim of this study was to assess the impact of point-of-care (POC) pre-PPCI creatinine and eGFR testing in STEMI patients. Methods 160 STEMI patients (STATCREAT group) with pre-procedure POC testing of Cr and eGFR were compared with 294 consecutive retrospective STEMI patients (control group). Patients were further divided into subjects with or without pre-existing CKD. Results: The incidence of CI-AKI in the whole population was 14.5% and not different between the two overall groups. For patients with pre-procedure CKD, contrast dose was significantly reduced in the STATCREAT group (124.6 ml vs. 152.3 ml, p = 0.015). The incidence of CI-AKI was 5.9% (n = 2) in the STATCREAT group compared with 17.9% (n = 10) in the control group (p = 0.12). There was no difference in the number of lesions treated (1.118 vs. 1.196, p = 0.643) or stents used (1.176 vs. 1.250, p = 0.78). For non-CKD patients, there was no significant difference in contrast dose (172.4 ml vs. 158.4 ml, p = 0.067), CI-AKI incidence (16.7% vs. 13.4%, p = 0.4), treated lesions (1.167 vs. 1.164, p = 1.0) or stents used (1.214 vs. 1.168, p = 0.611) between the two groups. Conclusions: Pre-PPCI point-of-care renal function testing did not reduce the incidence of CI-AKI in the overall group of STEMI patients. In patients with CKD, contrast dose was significantly reduced, but a numerical reduction in CI-AKI was not found to be statistically significant. No significant differences were found in the non-CKD group.

Item Type: Journal Article
Keywords: STEMI, Primary PC, Contrast-induced AKI
Faculty: Faculty of Medical Science
Depositing User: Ian Walker
Date Deposited: 02 Feb 2018 14:57
Last Modified: 17 Oct 2018 10:58
URI: http://arro.anglia.ac.uk/id/eprint/702698

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