AKI in Acute Coronary Syndrome: Prevalence and Risk Factors

Background: Acute Coronary Syndrome (ACS) often leads to acute kidney injury (AKI), affecting 15% of ACS patients. AKI increases mortality and hospital stays, with significant incidence even without contrast exposure. Understanding ACS-induced AKI's prevalence and long-term impact remains incomplete. The primary objective of this study is to determine the prevalence of AKI in patients presenting with ACS. Methods: This retrospective cohort study reviewed adult patients admitted with acute chest pain and suspected ACS at a university teaching hospital over a 12-month period in 2021. Patients on chronic dialysis or with incomplete information were excluded. Confirmed ACS was defined by discharge diagnoses of NSTEMI, STEMI, or unstable angina. Data on demographic, clinical, and laboratory data, including comorbidities, renal function, cardiac troponin level, and clinical outcome were retrieved and reviewed. Results: During the study, 21,328 patients hospitalized for suspected ACS were analyzed, of whom 6,685 had a confirmed ACS diagnosis. AKI was significantly more common in patients with confirmed ACS than the others (67.5% vs 30.9%, p < 0.0001). For patients with confirmed ACS, 65.0% of the AKI episodes were present at the time of hospital admission, and 15.2% of them had further progression during hospital stay. Neither the use of iodinated contrast or percutaneous coronary procedure was an independent predictor of all AKI, AKI episodes that developed during hospital stay, or worsening of AKI during hospital stay. Conclusion: AKI is common in patients admitted to hospital for ACS. Most AKI episodes were present at the time of hospital admission. Exposure to radio-contrast or percutaneous coronary procedure was associated with AKI episodes that developed during hospital stay, or worsening of AKI during hospitalization.