Preprocedural N-terminal pro-brain natriuretic peptide (NT-proBNP) is similar to the Mehran contrast-induced nephropathy (CIN) score in predicting CIN following elective coronary angiography.
Preprocedural N-terminal pro-brain natriuretic peptide (NT-proBNP) is similar to the Mehran contrast-induced nephropathy (CIN) score in predicting CIN following elective coronary angiography.
复制标题
DOI：
10.1161/jaha.114.001410
复制
发表时间：
2015-04-17
影响因子：
5.4
通讯作者：
Chen PY
中科院分区：
文献类型：
--
作者：
Liu Y;He YT;Tan N;Chen JY;Liu YH;Yang DH;Huang SJ;Ye P;Li HL;Ran P;Duan CY;Chen SQ;Zhou YL;Chen PY
N端脑钠素原(NT-proBNP)是造影剂肾病(CIN)的重要危险因素。然而，很少有研究研究NT-proBNP本身的预测价值。这项研究调查了术前NT-ProBNP水平是否能像Mehran CIN评分一样有效地预测择期冠状动脉造影术后的CIN。我们对2248例择期冠状动脉造影术患者进行了回顾性观察。通过受试者操作特征和多变量Logistic回归分析评价术前NT-ProBNP对CIN的预测价值。发生CIN的50例患者(2.2%)有较高的Mehran危险评分(9·5±5·1比4·8±3·8)和术前NT-ProBNP水平(53·20±74·23比1,078±25·48pg/mL，P<；0.001)。受试者操作特征分析显示，NT-ProBNP与Mehran CIN评分对CIN的预测差异无统计学意义(C=0.7657，C=0.7729，P=0.8431)。以NT-proBNP的682pg/ml为临界值预测CIN的敏感性为78%，特异性为70%。多因素分析显示，调整其他危险因素后，NT-proBNP和Gt；682pg/mL与CIN(优势比：4.007，95%CI：1.950~8.234；P<；0.001)和死亡风险(危险比：2.53；95%CI：1.49~4.3；P=0.0006)显著相关。术前NT-proBNP和GT；682pg/ml与CIN和死亡的风险显著相关。NT-proBNP和Mehran CIN评分一样，可能是CIN和死亡风险评估的另一种有用和快速的筛查工具，确定需要采取治疗措施预防CIN的受试者。
N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) has been associated with important risk factors for contrast‐induced nephropathy (CIN). However, few studies have investigated the predictive value of NT‐proBNP itself. This study investigated whether levels of preprocedural NT‐proBNP could predict CIN after elective coronary angiography as effectively as the Mehran CIN score. We retrospectively observed 2248 patients who underwent elective coronary angiography. The predictive value of preprocedural NT‐proBNP for CIN was assessed by receiver operating characteristic and multivariable logistic regression analysis. The 50 patients (2.2%) who developed CIN had higher Mehran risk scores (9.5±5.1 versus 4.8±3.8), and higher preprocedural levels of NT‐proBNP (5320±7423 versus 1078±2548 pg/mL, P<0.001). Receiver operating characteristic analysis revealed that NT‐proBNP was not significantly different from the Mehran CIN score in predicting CIN (C=0.7657 versus C=0.7729, P=0.8431). An NT‐proBNP cutoff value of 682 pg/mL predicted CIN with 78% sensitivity and 70% specificity. Multivariable analysis suggested that, after adjustment for other risk factors, NT‐proBNP >682 pg/mL was significantly associated with CIN (odds ratio: 4.007, 95% CI: 1.950 to 8.234; P<0.001) and risk of death (hazard ratio: 2.53; 95% CI: 1.49 to 4.30; P=0.0006). Preprocedural NT‐proBNP >682 pg/mL was significantly associated with the risk of CIN and death. NT‐proBNP, like the Mehran CIN score, may be another useful and rapid screening tool for CIN and death risk assessment, identifying subjects who need therapeutic measures to prevent CIN.