Is gender an independent risk factor for AKI in STEMI patients?

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Patients undergoing percutaneous coronary interventions (PCI) are prone to a wide range of complications, one complication that is constantly correlated with worse prognosis is acute kidney injury (AKI). Gender as an independent risk factor for said complications raised some interest yet studies showed conflicting results so far. Purpose We aimed to investigate the possible relation of gender on the occurrence of AKI among ST elevation myocardial infarction (STEMI) patients undergoing PCI. Methods This retrospective observational study cohort included 2967 consecutive patients admitted with STEMI between the years 2008-2019. Their renal outcomes ware assessed according to KDIGO criteria (AKI- serum creatinine ≥ 0.3 mg/dl from baseline within 48 hours from admission) and in-hospital complications and mortality were reviewed. Results Study population included 544 females and 2400 males. Female patients were older and with more co-morbidities. The occurrence of AKI was significantly higher among females (12.7% vs. 7.8%, p<0.001). Furthermore, among patients with AKI, severe AKI (defined as more than doubling on serum creatinine) was also more prevalent in females (26.1% vs. 14.5%, p=0.03). In general, AKI was associated with higher rates of in hospital complications and mortality in the entire cohort, while females demonstrated significantly higher rates of bleeding (8.9% vs. 3.7%, p<0.001), need for hemodynamic support (4.4% vs. 2.3%, p<0.001) and mortality (4.3% vs. 1.3 %, p<0.001) only in the "no AKI" group (figure 1). However, in multivariate analysis, after adjusting for the baseline characteristics, female gender was a nonsignificant predictor for AKI (adjusted OR 1.01, 95% CI 0.73-1.4, p=0.94) and for severe AKI (adjusted OR 1.65, 95% CI 0.80-1.65, p=0.18). Conclusions While females had higher rates of AKI and severe AKI, gender was non-significant as an independent risk factor after adjusting for other confounding variables. Other comorbidities that were more prevalent in females can account for the difference of AKI between the genders.