High Plasma Exposure of Statins Associated With Increased Risk of Contrast-Induced Acute Kidney Injury in Chinese Patients With Coronary Artery Disease.
High Plasma Exposure of Statins Associated With Increased Risk of Contrast-Induced Acute Kidney Injury in Chinese Patients With Coronary Artery Disease.
复制标题
他汀类药物的高血浆暴露与中国冠心病患者造影剂诱发的急性肾损伤风险增加相关
DOI：
10.3389/fphar.2018.00427
复制
发表时间：
2018
影响因子：
5.6
通讯作者：
Zhong S
中科院分区：
文献类型：
--
作者：
Cai L;Bai X;Lei H;Wu H;Liu Y;Zhu Q;Zhang S;Liu Y;Lin Q;Chen J;Zhang B;He G;Geng Q;Huang M;Zhong S
他汀类药物在降低造影剂诱导的急性肾损伤（CI-AKI）发生率方面的作用仍存在争议。我们试图评估接受冠状动脉造影（CAG）的冠状动脉疾病（CAD）患者CI-AKI与他汀类药物高血浆暴露之间的关系。这种关联首先在1219例接受阿托伐他汀（AT）治疗的CAD患者中进行了评估，并在635例接受瑞舒伐他汀（RST）治疗的患者中得到了验证。采用经过验证的UPLC-MS/MS方法定量测定他汀类药物的血药浓度，并评估术后48小时CI-AKI发生率。在所有参与者（n = 1854）中，AT组1219例中有57例（4.7%）发生AKI， RST组635例中有30例（4.7%）发生AKI。高血浆AT-all暴露与CI- aki风险增加相关（优势比[OR]: 2.265； 95%可信区间[CI]: 1.609-3.187; p < 0.0001）。CI-AKI组血浆AT-all浓度（22.40±24.63 ng/mL）比对照组（8.60±9.65 ng/mL）高2.6倍。高血浆RST暴露也显著增加CI- aki的风险（OR: 2.281; 95% CI: 1.441-3.612; p = 0.0004）。我们进一步根据基线肾功能将患者分为两个亚组，高血浆他汀类药物暴露与CI-AKI之间的相关性在两个亚组中仍然非常显著。本研究首次提示高血浆暴露于他汀类药物可能显著增加CI-AKI的风险。在行CAG的冠心病患者中，他汀类药物的使用应更加谨慎，以减少CI-AKI的发生。
The role of statins in reducing the incidence of contrast-induced acute kidney injury (CI-AKI) remains controversial. We sought to evaluate the association between CI-AKI and high plasma exposure of statins in coronary artery disease (CAD) patients undergoing coronary angiography (CAG). This association was first evaluated in 1,219 patients with CAD receiving atorvastatin (AT) therapy and validated in 635 patients receiving rosuvastatin (RST) therapy. The plasma concentrations of statins were quantified using validated UPLC-MS/MS methods and CI-AKI incidence was assessed during the first 48 h postoperatively. Among all participants (n = 1,854), AKI occurred in 57 of 1219 (4.7%) in the AT cohort and 30 of 635 (4.7%) in the RST cohort. High plasma AT-all exposure was associated with increased risk of CI-AKI (odds ratio [OR]: 2.265; 95% confidence interval [CI]: 1.609–3.187; p < 0.0001). Plasma AT-all concentration in the CI-AKI group (22.40 ± 24.63 ng/mL) was 2.6-fold higher than that in the control group (8.60 ± 9.65 ng/mL). High plasma RST exposure also significantly increased the risk of CI-AKI (OR: 2.281; 95% CI: 1.441–3.612; p = 0.0004). We further divided patients into two subgroups for each statin according to baseline renal function, and association between high plasma statin exposure and CI-AKI still remained highly significant in both subgroups. This study suggests for the first time that high plasma exposure of statins may significantly increase the risk of CI-AKI. Statins should be used with greater caution in CAD patients undergoing CAG to reduce the occurrence of CI-AKI.
登录
查看更多内容
短期大剂量他汀类药物预防造影剂肾病的疗效：七项随机对照试验的荟萃分析
影响因子：
3.7
作者：
Li Y;Liu Y;Fu L;Mei C;Dai B
通讯作者：
Dai B
DOI：
10.1186/s13054-014-0606-x
发表时间：
2014-11-20
期刊：
Critical care (London, England)
影响因子：
--
作者：
Birnie K;Verheyden V;Pagano D;Bhabra M;Tilling K;Sterne JA;Murphy GJ;UK AKI in Cardiac Surgery Collaborators
通讯作者：
UK AKI in Cardiac Surgery Collaborators
DOI：
10.1161/circgenetics.113.000099
发表时间：
2013-08
期刊：
Circulation. Cardiovascular genetics
影响因子：
--
作者：
DeGorter MK;Tirona RG;Schwarz UI;Choi YH;Dresser GK;Suskin N;Myers K;Zou G;Iwuchukwu O;Wei WQ;Wilke RA;Hegele RA;Kim RB
通讯作者：
Kim RB
影响因子：
39.3
作者：
Ikeda, Nobutaka;Kogame, Norihiro;Sugi, Kaoru
通讯作者：
Sugi, Kaoru
影响因子：
2.3
作者：
Arora P;Gupta A;Golzy M;Patel N;Carter RL;Jalal K;Lohr JW
通讯作者：
Lohr JW