Acute Hyperglycemia an Independent Risk Factor for Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention for STEMI

Background Patients undergoing primary PCI are at high risk for contrast induced nephropathy CIN a complication that has a serious impact on in hospital outcome Acute hyperglycemia is common in patients with STEMI even in the absence of history of DM and has been identified as a major predictor of in hospital mortality and morbidity Objective To determine the association between admission acute hyperglycemia and the risk of subsequent CIN in patients with STEMI undergoing primary PCI Patients and Methods The study included patients who presented with acute STEMI and were treated with primary PCI The patients were divided into groups Group A Included patients with acute hyperglycemia blood glucose gt mg dl Group B Included patients without acute hyperglycemia on admission Serum creatinine was measured at the time of admission and daily for the following days CIN was defined as an increase of ge or an absolute increase of ge mg dl in serum creatinine level Results There was a statistically significant difference regarding the incidence of CIN and need for dialysis between both groups where CIN occurred in patients of which patients required dialysis in group A while in group B CIN occurred in patients of which none needed dialysis P lt In hospital adverse events occurred more frequently in group A than group B In Group A patients had acute pulmonary oedema APO cardiogenic shock and needed mechanical ventilation On the other hand in Group B patients had APO and patient had cardiogenic shock and required mechanical ventilation P lt Overall in hospital mortality of the study population was n all of which were in group A P lt Conclusion In patients undergoing primary PCI acute hyperglycemia is associated with increased incidence of CIN as well as increased incidence of in hospital adverse events and in hospital mortality