Impact of Acute kidney Injury on In-hospital Outcome of Patients with First Attack of Acute Myocardial Infarction

Background: Acute kidney injury (AKI) is a frequent complication of acute myocardial infarction (AMI) and is associated with adverse clinical outcomes. Objective: This study evaluated the association between AKI and in-hospital heart failure, arrhythmia, cardiogenic shock, and mortality in patients with a first attack of AMI. Methods: This cross-sectional observational study was conducted in the Department of Cardiology, Mymensingh Medical College Hospital, from August 2017 to October 2018. A total of 401 patients with first-attack AMI were enrolled and divided into AKI and non-AKI groups. Serum creatinine was measured on admission and after 48 hours to diagnose AKI. In-hospital major cardiac events were recorded and analyzed. Results: AKI occurred in 24.2% of patients. The mean age was higher in the AKI group than in the non-AKI group (60.08±12.48 vs. 52.27±11.90 years). Hypertension was significantly more common among patients with AKI (37.1% vs. 21.4%, p\<0.001). Heart failure (92.8% vs. 11.2%), cardiogenic shock (9.3% vs. 1.6%), arrhythmia (11.3% vs. 2.6%), and mortality (9.3% vs. 1.6%) were significantly higher in the AKI group (p\<0.001). AKI showed significant positive correlations with age (r=0.232), heart failure (r=0.640), cardiogenic shock (r=0.149), arrhythmia (r=0.157), and death (r=0.171). Hypertension was also positively correlated with AKI (r=0.114), while smoking showed a weak correlation (r=0.087). Conclusion: AKI in patients with first-attack AMI is significantly associated with adverse in-hospital outcomes, including heart failure, cardiogenic shock, arrhythmia, and mortality.