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血清白蛋白水平对接受经皮冠状动脉介入治疗的急性冠状动脉综合征患者造影剂诱导的急性肾损伤的影响。

Impact of Serum Albumin Levels on Contrast-Induced Acute Kidney Injury in Patients With Acute Coronary Syndromes Treated With Percutaneous Coronary Intervention.

作者信息

Murat Sani Namik, Kurtul Alparslan, Yarlioglues Mikail

机构信息

Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey

Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.

出版信息

Angiology. 2015 Sep;66(8):732-7. doi: 10.1177/0003319714551979. Epub 2014 Sep 26.

Abstract

Patients with acute coronary syndromes (ACSs) undergoing percutaneous coronary intervention (PCI) are at high risk of contrast-induced acute kidney injury (CI-AKI), a complication associated with poor clinical outcomes. Serum albumin (SA) levels are associated with cardiovascular mortality. We assessed the association between SA levels and the risk of CI-AKI in patients with ACS (n = 890) treated with PCI. Patients were divided into 2 groups: patients with and without CI-AKI. Contrast-induced acute kidney injury was defined as an increase in serum creatinine (≥25% or ≥0.5 mg/dL) from baseline occurring 72 hours after PCI. The SA levels were significantly lower in patients with CI-AKI than in those without CI-AKI (3.52 ± 0.40 vs 3.94 ± 0.39 mg/dL, P < .001). On multivariate analysis, SA was an independent predictor of CI-AKI (odds ratio 0.177, 95% confidence interval 0.080-0.392, P < .001) together with age, female gender, creatine kinase-myocardial band, and glomerular filtration rate. Baseline SA levels are inversely associated with CI-AKI after PCI for ACS.

摘要

接受经皮冠状动脉介入治疗(PCI)的急性冠状动脉综合征(ACS)患者发生造影剂诱导的急性肾损伤(CI-AKI)的风险很高,这是一种与不良临床结局相关的并发症。血清白蛋白(SA)水平与心血管死亡率相关。我们评估了SA水平与接受PCI治疗的ACS患者(n = 890)发生CI-AKI风险之间的关联。患者被分为两组:发生CI-AKI的患者和未发生CI-AKI的患者。造影剂诱导的急性肾损伤定义为PCI术后72小时血清肌酐较基线水平升高(≥25%或≥0.5 mg/dL)。发生CI-AKI的患者的SA水平显著低于未发生CI-AKI的患者(3.52±0.40 vs 3.94±0.39 mg/dL,P <.001)。多因素分析显示,SA与年龄、女性性别、肌酸激酶-心肌型、肾小球滤过率一起是CI-AKI的独立预测因素(比值比0.177,95%置信区间0.080-0.392,P <.001)。ACS患者PCI术后基线SA水平与CI-AKI呈负相关。

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