A síndrome metabólica como fator de risco para injúria renal aguda em pacientes com infarto agudo do miocárdio

Abstract

Acute myocardial infarction (AMI) is one of the leading causes of death world widely, and acute kidney injury (AKI) is a common complication after admission due to AMI. Metabolic syndrome (MS) is a very prevalent condition in patients with AMI, but data on its influence on the development of AKI in this clinical context are scarce. Objective: To analyze whether MS is a risk factor for the development of AKI in hospitalized patients diagnosed with AMI. Patients and Methods: This is a single-center, cohort, observational study that evaluated patients with AMI from a prospective data bank in order to assess the role of MS as an independent risk factor for the development of AKI. A total of 1,012 patients admitted with acute ST-elevation myocardial infarction (STEMI) and acute non-ST-segment elevation myocardial infarction (non-STEMI) were included. The diagnostic criterion for AKI was the Kidney Disease: Improving Global Outcomes (KDIGO) definition, during the first seven days of hospitalization. The criterion for SM was the Joint Interim Statement (JIS) definition. Results: The diagnosis of AKI occurred in 34% and MS in 68.6% of the total cohort. Patients with MS developed AKI more frequently (38.3% versus 24.5% no MS, p <0.001). In the multivariate analysis MS was not associated with an increased risk of developing AKI. The factors associated with a higher risk of AKI in the multivariate analysis were male gender (odds ratio [OR] 1.50, 95% confidence interval [CI] 1.05-2.13, p=0.023), diabetes, 95% CI 1.33-2.76, p<0.001), anterior wall STEMI (OR 1.50 95% CI 1.04-2.16, p=0.030), use of vasoactive drugs (OR 2.90 95% CI 1.52-5.51, p=0.001) and diuretic therapy (OR 4.41 95% CI 3.10-6.29, p<0.001). Two factors were associated with a lower risk of AKI: coronary angiography (OR 0.35 95% CI 0.25-0.50, p<0.001) and coronary artery bypass graft (OR 0.05 CI 95% 0.02-0.18, p<0.001) performed during the first seven days of hospital staying. Conclusion: MS was not an independent risk factor for the development of AKI after admission due to AMI.