Uzunhasan Isil, Yildiz Ahmet, Arslan Sukru, Abaci Okay, Kocas Cuneyt, Kocas Betul Balaban, Cetinkal Gokhan, Dalgic Yalcin, Karaca Osman Sukru, Dogan Sait Mesut
1 Department of Cardiology, Cardiology Institute of Istanbul University, Istanbul University, Istanbul, Turkey.
2 Department of Cardiology, Gaziosmanpasa Taksim Training and Research Hospital, Istanbul, Turkey.
Angiology. 2017 Aug;68(7):621-626. doi: 10.1177/0003319716676173. Epub 2016 Nov 12.
Contrast-induced acute kidney injury (CI-AKI) is associated with increased mortality, morbidity, and prolonged hospitalization. Patients with acute coronary syndrome (ACS) have a 3-fold higher risk of developing CI-AKI. The aim of our study was to evaluate the predictors of CI-AKI and long-term prognosis in patients with ACS who developed CI-AKI (1083 patients were enrolled). Contrast-induced acute kidney injury was defined as an increase of ≥0.5 mg/dL and/or an increase of ≥25% of pre-percutaneous coronary intervention (PCI) to post-PCI serum creatinine levels within 48 to 72 hours after the procedure. Primary end point was defined as all-cause mortality, myocardial infarction, and cerebrovascular event at long-term follow-up (36 ± 12 months). Contrast-induced acute kidney injury occurred in 178 (16.4%) of the 1083 patients. The primary end points were significantly high in patients with ACS who developed CI-AKI ( P < .001). The occurrence of CI-AKI was identified as an independent predictor of primary end point. Risk of CI-AKI development was more frequently seen in patients with ACS. Also, patients who developed CI-AKI have worse prognosis at long-term follow-up. Additional preventive treatment strategies need to be developed in this group of patients.
对比剂诱导的急性肾损伤(CI-AKI)与死亡率增加、发病率增加及住院时间延长相关。急性冠状动脉综合征(ACS)患者发生CI-AKI的风险高3倍。我们研究的目的是评估发生CI-AKI的ACS患者中CI-AKI的预测因素及长期预后(纳入了1083例患者)。对比剂诱导的急性肾损伤定义为在经皮冠状动脉介入治疗(PCI)术后48至72小时内,血清肌酐水平较PCI术前升高≥0.5mg/dL和/或升高≥25%。主要终点定义为长期随访(36±12个月)时的全因死亡率、心肌梗死和脑血管事件。1083例患者中有178例(16.4%)发生了对比剂诱导的急性肾损伤。发生CI-AKI的ACS患者的主要终点显著更高(P<.001)。CI-AKI的发生被确定为主要终点的独立预测因素。ACS患者发生CI-AKI的风险更常见。此外,发生CI-AKI的患者在长期随访中的预后更差。需要为这组患者制定额外的预防治疗策略。