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主动脉僵硬度增加可预测行经皮冠状动脉介入治疗的稳定性冠心病患者的对比剂肾病。

Increased aortic stiffness predicts contrast-induced nephropathy in patients with stable coronary artery disease undergoing percutaneous coronary intervention.

机构信息

Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey

Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.

出版信息

Angiology. 2014 Oct;65(9):806-11. doi: 10.1177/0003319713504126. Epub 2013 Sep 26.

Abstract

Increased aortic stiffness (AS) has been shown to be an independent risk factor for cardiovascular disease in renal failure and was also found to be associated with even mild renal insufficiency. We investigated the relationship between contrast-induced nephropathy (CIN) and AS parameters such as pulse wave velocity (PWV) and augmentation index (AIx). Patients (n = 440) with stable coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI) were included prospectively (mean age: 60.3 ± 10.3 years). The PWV and AIx were calculated using the single-point method. The PWV, age, diabetes, SYNTAX score, and contrast media dose were independent predictors for CIN (P < .05, for all). The cutoff value for PWV obtained by the receiver-operator characteristic curve analysis was 10.35 m/s for the prediction of CIN (95% confidence interval: 0.838-0.916, sensitivity: 82.1%, specificity: 77.9%, and P < .001). In conclusion, a greater AS pre-PCI may predict CIN development in patients with stable CAD.

摘要

已经证实,主动脉僵硬度(AS)增加是肾功能衰竭患者心血管疾病的一个独立危险因素,而且即使是轻度肾功能不全也与 AS 相关。我们研究了对比剂肾病(CIN)与 AS 参数(如脉搏波速度(PWV)和增强指数(AIx))之间的关系。前瞻性纳入了 440 例接受经皮冠状动脉介入治疗(PCI)的稳定性冠心病(CAD)患者(平均年龄:60.3±10.3 岁)。使用单点法计算 PWV 和 AIx。PWV、年龄、糖尿病、SYNTAX 评分和对比剂剂量是 CIN 的独立预测因子(均 P<.05)。受试者工作特征曲线分析得出的 PWV 截断值为 10.35m/s,用于预测 CIN(95%置信区间:0.838-0.916,敏感性:82.1%,特异性:77.9%,P<.001)。总之,PCI 前更大的 AS 可能预测稳定 CAD 患者 CIN 的发生。

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