Heart attack delay may signal kidney risk after angioplasty

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Inclusion Criteria: 1. Patients aged \>=18 years at the time of presentation. 2. Definitive diagnosis of acute ST-segment elevation myocardial infarction (STEMI) presenting within 12 hours of symptom onset, characterized by typical ischemic symptoms (e.g., retrosternal chest pain) and electrocardiographic criteria: persistent ST-segment elevation \>=1 mm in \>=2 contiguous limb leads, or \>=2 mm in \>=2 contiguous precordial leads (V2-V3 thresholds: \>=2.5 mm in men \<40 years, \>=2.0 mm in men \>=40 years, and \>=1.5 mm in women), or a validated new or presumably new left bundle branch block (LBBB). 3. Selection for immediate mechanical reperfusion via emergency primary percutaneous coronary intervention (PPCI) according to current guidelines. 4. A reliable and verifiable chronological timeline regarding the exact onset of chest pain or ischemic symptoms to ensure precise calculation of the total ischemic duration. 5. Willingness to participate, demonstrated by signed, informed consent obtained from the patient or an authorized family representative prior to data collection under approved institutional protocols. . Exclusion Criteria: <!-- --> 1. Pre-existing end-stage renal disease (ESRD) requiring long-term peritoneal dialysis or hemodialysis, or an admission baseline eGFR \<15 mL/min/1.73m2. 2. Prior exposure to iodinated contrast media within the past 7 days, or scheduled elective contrast procedures within the subsequent 72 hours. 3. Intentional pre-procedural administration of structured, high-volume intravenous fluid hydration regimens specifically designed to prevent contrast nephropathy (e.g., sodium bicarbonate protocols), which would confound baseline renal kinetics. 4. Known active treatment with high-potency nephrotoxic drugs within the 48 hours prior to admission (e.g., cisplatin, high-dose aminoglycosides, amphotericin B). 5. Active pregnancy, ongoing breastfeeding, or severe non-cardiac co-morbidities associated with a life expectancy \<30 days (e.g., advanced terminal malignancies)