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性别对行冠状动脉造影或经皮冠状动脉介入治疗患者对比剂肾病风险的影响。

Gender Difference in the Risk of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography or Percutaneous Coronary Intervention.

机构信息

1 Division of Cardiology, Azienda Ospedaliera-Universitaria "Maggiore della Carità," Eastern Piedmont University, Novara, Italy.

2 Department of Cardiology, UMC St Radboud, Nijmegen, the Netherlands.

出版信息

Angiology. 2017 Jul;68(6):542-546. doi: 10.1177/0003319716669429. Epub 2016 Sep 22.

Abstract

Contrast-induced nephropathy (CIN) is a common complication of coronary angiography/percutaneous coronary intervention (PCI). Identification of high-risk patients and optimal periprocedural management are key points to reduce the incidence of this iatrogenic complication. We evaluated the impact of gender on CIN after coronary angiography/PCI. We enrolled 2851 consecutive patients (730 females and 1851 males) undergoing coronary angiography/PCI. Baseline clinical and procedural characteristics were collected according to gender. CIN was defined as an absolute ≥0.5mg/dL or a relative ≥25% increase in creatinine level 24 to 48 hours after the procedure. The incidence of CIN was 12.6% and was significantly higher among females (15.6% vs 11.4%, odds ratio (OR) [95% confidence interval (CI)] = 1.42 [1.11-1.82]; P = .004), but this result was not confirmed at multivariate analysis after correction for all baseline confounders (adjusted OR [95% CI] = 1.14 [0.81-1.60]; P = 0.45). In conclusion, we showed that female gender is associated with an increased risk of CIN after coronary angiography/PCI. However, this finding was not confirmed after correction for baseline confounders. Therefore, the higher risk profile rather than female gender itself may contribute to the higher occurrence of CIN among women.

摘要

对比剂肾病(CIN)是冠状动脉造影/经皮冠状动脉介入治疗(PCI)的常见并发症。确定高危患者和优化围手术期管理是降低这种医源性并发症发生率的关键。我们评估了性别对冠状动脉造影/PCI 后 CIN 的影响。我们纳入了 2851 例连续患者(女性 730 例,男性 1851 例),行冠状动脉造影/PCI。根据性别收集基线临床和手术特征。CIN 的定义为术后 24 至 48 小时肌酐水平绝对升高≥0.5mg/dL 或相对升高≥25%。CIN 的发生率为 12.6%,女性明显更高(15.6%比 11.4%,比值比(OR)[95%置信区间(CI)]为 1.42 [1.11-1.82];P =.004),但在所有基线混杂因素校正后多变量分析中未得到证实(校正 OR [95% CI] = 1.14 [0.81-1.60];P = 0.45)。总之,我们表明女性性别与冠状动脉造影/PCI 后 CIN 风险增加相关。然而,在对基线混杂因素进行校正后,这一发现并未得到证实。因此,较高的风险状况而不是女性性别本身可能导致女性 CIN 发生率更高。

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