Catheterization and Cardiovascular Interventions 82:886–887 (2013)

Editorial Comment As the kidney goes, so goes the heart. . . Harkawal S. Hundal, MD, MS and Joaquin E. Cigarroa,* MD Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon 97239-3098

Although acute kidney injury (AKI) in patients undergoing angiography in acute coronary syndrome is attributed to contrast induced nephropathy (CIN) and is associated with increased morbidity and mortality, AKI also has prognostic implication in almost all hospitalized conditions. The mortality of hospitalized patients with severe AKI requiring renal replacement therapy ranges from 21 to 70%, a rate up to five times higher than those without AKI [1]. Various models have been developed to predict the risk for AKI or CIN in setting of percutaneous coronary intervention (PCI). Mehran and colleagues developed a risk calculator utililzing hypotension, age, congestive heart failure, diabetes, anemia, contrast media, and kidney function [2]. In the highest risk category, the risk of CIN was 57%, risk of inpatient dialysis was 12.6% and 1 year mortality was >30%. The study population included 36% of patients with acute coronary syndrome, of which 16% developed CIN. Overall, the risk for CIN was 13.1%. In the current issue of Catheterization and Cardiovascular Interventions, Ando and colleagues present a simplified risk calculator composed of three variables to predict CIN in patients with acute myocardial infarction undergoing primary PCI: age, estimated glomerular filtration rate (eGFR) derived from the modification of diet in renal disease (MDRD) formula and left ventricular ejection fraction (EF) [3]. Using these variables, they calculate the AGEF score with the formula (age/%EF) þ1 if eGFR is

As the kidney goes, so goes the heart….

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