Data about contrast-associated acute kidney injury (CA-AKI) in oldest old (age ≥85 years) ST-elevation myocardial infarction (STEMI) patients are scarce. We evaluated the incidence and the 1-year prognostic impact of CA-AKI in this population. Patients were included in a multicenter real-world registry, and CA-AKI was defined according to KDIGO (Kidney Disease Improving Global Outcomes) criteria. Major adverse cardiac and cerebrovascular events (MACCEs) were defined as the composite of all-cause death, stroke, unplanned coronary revascularization, and heart failure hospitalization. The primary outcome was the incidence and impact of CA-AKI on MACCEs at 1 year follow-up. Out of 461 STEMI patients (mean age 88.6 ± 2.9 years), 102 (22.1%) patients developed CA-AKI. Chronic kidney disease was the strongest predictor of CA-AKI (odds ratio [OR]: 4.52, 95% CI: 2.81–7.30, P < .01). The CA-AKI cohort showed a higher risk of MACCEs (adjusted HR: 1.75, 95% CI: 1.13–2.71, P = .01), driven mainly by all-cause death (adjusted hazard ratio [HR]: 2.39, 95% CI: 1.41–4.07, P = .01) and followed by heart failure hospitalization (adjusted HR: 2.01, 95% CI: 1.08–3.76, P = .01). Among oldest old STEMI, CA-AKI was frequent and associated with a higher incidence of MACCEs at 1-year follow-up.

中文翻译：

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对比相关急性肾损伤对高龄 STEMI 患者一年结果的影响：来自意大利北部多中心登记的见解

关于年龄最大（年龄≥85岁）ST段抬高型心肌梗死（STEMI）患者的对比剂相关急性肾损伤（CA-AKI）的数据很少。我们评估了该人群中 CA-AKI 的发病率和 1 年预后影响。患者被纳入多中心真实世界登记中，CA-AKI 是根据 KDIGO（改善全球肾脏疾病结果）标准定义的。主要不良心脑血管事件（MACCE）被定义为全因死亡、中风、计划外冠状动脉血运重建和心力衰竭住院的复合事件。主要结局是 1 年随访时 CA-AKI 的发生率和对 MACCE 的影响。在 461 名 STEMI 患者（平均年龄 88.6 ± 2.9 岁）中，102 名（22.1%）患者出现 CA-AKI。慢性肾脏病是 CA-AKI 最强的预测因子（比值比 [OR]：4.52，95% CI：2.81–7.30，P < .01）。CA-AKI 队列显示 MACCE 风险较高（调整后 HR：1.75，95% CI：1.13–2.71，P = 0.01），主要由全因死亡驱动（调整后风险比 [HR]：2.39，95%） CI：1.41–4.07，P = .01），然后是心力衰竭住院（调整后的 HR：2.01，95% CI：1.08–3.76，P = .01）。在年龄最大的 STEMI 患者中，CA-AKI 很常见，并且与 1 年随访时 MACCE 的发生率较高相关。