1 Department of Cardiology, Mersin State Hospital, Mersin, Turkey.
2 Department of Cardiology, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey.
Angiology. 2017 Nov;68(10):871-876. doi: 10.1177/0003319717699328. Epub 2017 Mar 21.
We investigated the relationship between atrial fibrillation (AF) and contrast-induced nephropathy (CIN) in patients with non-ST-segment elevation myocardial infarction (NSTEMI); 1045 consecutive patients undergoing percutaneous coronary interventions were enrolled. Risk factors for CIN were investigated. Baseline characteristics, except oral anticoagulant use, were similar between patients with and without AF. Patients with CIN show higher presence of diabetes mellitus (DM), coronary artery bypass graft surgery history, Mehran score, baseline creatinine levels, baseline glomerular filtration rate (GFR), peak troponin levels, left ventricular ejection fraction (LVEF), and presence of AF ( P < .05). In multivariate logistic regression analyses, the presence of DM (odds ratio [OR], 2.333; 95% confidence interval [CI], 1.222-4.457; P = .010), Mehran score (OR, 1.269; 95% CI, 1.152-1.398; P < .001), baseline GFR (OR, 0,954; 95% CI, 0.944-0.964 P < .001), left anterior descending artery originated infarction (OR, 1.594; 95% CI, 1.061-2.398; P = .025), LVEF value (OR, 0.956; 95% CI, 0.926-0.986; P = .005), and the presence of AF (OR, 3.830; 95% CI, 1.239-11.839; P = .020) were independent predictors of CIN. Atrial fibrillation can be related to CIN development in patients with NSTEMI.
我们研究了非 ST 段抬高型心肌梗死(NSTEMI)患者心房颤动(AF)与对比剂诱导的肾病(CIN)之间的关系;纳入了 1045 例接受经皮冠状动脉介入治疗的连续患者。研究了 CIN 的危险因素。除口服抗凝剂使用外,CIN 患者和无 CIN 患者的基线特征相似。CIN 患者的糖尿病(DM)、冠状动脉旁路移植术史、Mehran 评分、基线肌酐水平、基线肾小球滤过率(GFR)、峰值肌钙蛋白水平、左心室射血分数(LVEF)和 AF 发生率较高(P<0.05)。多变量逻辑回归分析显示,DM(比值比 [OR],2.333;95%置信区间 [CI],1.222-4.457;P=0.010)、Mehran 评分(OR,1.269;95% CI,1.152-1.398;P<0.001)、基线 GFR(OR,0.954;95% CI,0.944-0.964;P<0.001)、前降支起源性梗死(OR,1.594;95% CI,1.061-2.398;P=0.025)、LVEF 值(OR,0.956;95% CI,0.926-0.986;P=0.005)和 AF 存在(OR,3.830;95% CI,1.239-11.839;P=0.020)是 CIN 的独立预测因素。AF 可能与 NSTEMI 患者 CIN 的发展有关。