Abstract 15332: Obesity is Associated With Acute Kidney Injury in STEMI Undergoing PCI: A National Representative Cohort Study

Background: Acute kidney injury (AKI) is a frequent and serious complication after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). However, the relationship between obesity and the risk of AKI in this specific patient population has not been previously examined.

Methods: We conducted a retrospective analysis of adult discharges from the National Inpatient Sample (NIS) between 2016 and 2019. ICD-10 codes were used to identify patients with STEMI who undergoing PCI. All patients were further sub-categorized into obese and non-obese cohorts. The primary outcome was the incidence of AKI. Multivariable regression models adjusting for demographics, hospital characteristics, and co-morbidities were used to examine differences in AKI incidence in the two groups of patients. Subgroup analysis and interaction tests were used to test whether this relationship was stable across groups.

Results: A total of 62,599(weighted national estimate of 529,106) patients were included in the study, out of which 9.80% (n=6137) had AKI. Obese comprised 19.78% (n=1214) of the AKI cohort. Obese patients were on average younger, male, white race and had more comorbidities. There was a significant positive association between obesity and the incidence of AKI (aOR 1.20, 95% CI 1.10-1.31). This significant positive association was more pronounced in female patients (aOR 1.49, 95% CI 1.25-1.79, p<0.001, P-interaction=0.014). The incidence of AKI in STEMI patients after PCI increased steadily during the 4-year study period, and the adjusted trend showed that the incidence of AKI in obese patients was consistently higher than in non-obese patients.

Conclusions: Obesity was independently associated with a greater risk for acute kidney injury among adults with STEMI undergoing PCI, especially in female patients. Further studies examining management strategies and best practices in obese patients with STEMI are warranted.