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尿白蛋白对择期冠状动脉支架植入术患者围手术期心肌损伤发生率的影响。

Impact of albuminuria on the incidence of periprocedural myocardial injury in patients undergoing elective coronary stent implantation.

机构信息

Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Am J Cardiol. 2014 Jul 1;114(1):42-6. doi: 10.1016/j.amjcard.2014.03.058. Epub 2014 Apr 18.

Abstract

Albuminuria has traditionally been associated with an elevated risk of cardiovascular events. However, few studies have examined the potential relation between albuminuria and periprocedural risk in percutaneous coronary intervention (PCI). The aim of this study was to evaluate the impact of albuminuria on the incidence of periprocedural myocardial injury (PMI) in patients who underwent PCI. The study included 252 consecutive patients who underwent PCI. The incidence of PMI was significantly higher in patients with albuminuria than in those with normoalbuminuria (31.9% vs 43.3%, respectively, p = 0.014). Even after adjustment for confounders, the presence of albuminuria predicted PMI (odds ratio 2.07, 95% confidence interval 1.08 to 3.97, p = 0.029). Furthermore, patients with albuminuria and preserved estimated glomerular filtration rate had a 4.2-fold higher risk for PMI than did patients with normoalbuminuria and preserved estimated glomerular filtration rate. In conclusion, albuminuria was a strong predictor of PMI in patients who underwent PCI.

摘要

尿白蛋白传统上与心血管事件的风险升高有关。然而,很少有研究探讨尿白蛋白与经皮冠状动脉介入治疗(PCI)围手术期风险之间的潜在关系。本研究旨在评估尿白蛋白对行 PCI 患者围手术期心肌损伤(PMI)发生率的影响。该研究纳入了 252 例连续行 PCI 的患者。尿白蛋白患者的 PMI 发生率明显高于正常白蛋白尿患者(分别为 31.9%和 43.3%,p=0.014)。即使在校正混杂因素后,尿白蛋白的存在仍可预测 PMI(比值比 2.07,95%置信区间 1.08 至 3.97,p=0.029)。此外,尿白蛋白且估算肾小球滤过率正常的患者发生 PMI 的风险是正常白蛋白尿且估算肾小球滤过率正常的患者的 4.2 倍。总之,尿白蛋白是 PCI 患者 PMI 的一个强有力的预测因子。

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