Procalcitonin as an Early Predictor of Contrast-Induced Acute Kidney Injury in Patients With Acute Coronary Syndromes Who Underwent Percutaneous Coronary Intervention
Procalcitonin as an Early Predictor of Contrast-Induced Acute Kidney Injury in Patients With Acute Coronary Syndromes Who Underwent Percutaneous Coronary Intervention
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DOI：
10.1177/0003319715572218
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发表时间：
2015-11-01
期刊：
影响因子：
2.8
通讯作者：
Baris, Veysel Ozgur
中科院分区：
文献类型：
--
作者：
Kurtul, Alparslan;Murat, Sani Namik;Baris, Veysel Ozgur
造影剂诱导的急性肾损伤（CI-AKI）是经皮冠状动脉介入治疗（PCI）后的主要问题，尤其是在急性冠状动脉综合征（ACS）的情况下。造影剂引起的急性肾损伤与死亡率和发病率增加有关。炎症在CI-AKI的病理生理学中起重要作用。降钙素原（PCT）是一种新的炎症标志物。我们试图检查入院PCT水平是否预测CI-AKI的发展。将患者（n = 814）分为2组，即CI-AKI（-）和CI-AKI（+）。造影剂暴露后48 - 72小时内血清肌酐较基线升高0.5 mg/dL定义为CI-AKI。96例（11.8%）患者发生造影剂诱导的急性肾损伤。CI-AKI患者的PCT水平显著高于无CI-AKI患者，分别为0.11（0.056-0.495）和0.04（0.02-0.078）μ g/L; P <0.001。多变量分析后，PCT仍然是CI-AKI的显著独立预测因子（比值比2.544; 95% CI [1.207-5.347]; P = 0.014）以及年龄、女性、白色血细胞、血红蛋白、肾小球滤过率、肌酸激酶肌核带和SYNTAX评分。总之，血清PCT水平与接受紧急PCI的ACS患者的CI-AKI风险独立相关。
Contrast-induced acute kidney injury (CI-AKI) is a major issue after percutaneous coronary intervention (PCI), especially in the setting of acute coronary syndrome (ACS). Contrast-induced acute kidney injury is associated with increased mortality and morbidity. Inflammation plays an important role in the pathophysiology of CI-AKI. Procalcitonin (PCT) is introduced as a new marker of inflammation. We sought to examine whether admission PCT levels predict the development of CI-AKI. Patients (n = 814) were divided into 2 groups, namely, CI-AKI (-) and CI-AKI (+). An increase in serum creatinine of 0.5 mg/dL from baseline within 48 to 72 hours of contrast exposure was defined as CI-AKI. Contrast-induced acute kidney injury occurred in 96 (11.8%) patients. The PCT levels were significantly higher in patients with CI-AKI than in those without, 0.11 (0.056-0.495) vs 0.04 (0.02-0.078) mu g/L; P < .001. After multivariable analysis, PCT remained a significant independent predictor of CI-AKI (odds ratio 2.544; 95% CI [1.207-5.347]; P = .014) as well as age, women, white blood cell, hemoglobin, glomerular filtration rate, creatine kinase myocarial band, and SYNTAX score. In conclusion, serum PCT levels are independently associated with a risk of CI-AKI in patients with ACS who underwent urgent PCI.