Department of Cardiology, Zhongda Hospital of Southeast University Medical School, Nanjing 210009, China.
Biomed Res Int. 2019 Jan 23;2019:9357203. doi: 10.1155/2019/9357203. eCollection 2019.
Contrast-induced nephropathy (CIN) is a relatively infrequent complication after percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). However, little is known about the association between cytochrome c (cyt c) and increased risk of CIN. We conducted this study to explore the impact of serum cyt c on the occurrence of CIN.
We prospectively examined cyt c levels before undergoing PCI in 240 patients with STEMI. The logistic regression was performed to identify the independent risk factors for the occurrence of CIN. The receiver operating characteristic (ROC) analysis was employed to evaluate the predictive value of cyt c for the occurrence of CIN.
29 patients (12.1%) had developed CIN after the PCI procedure. The cyt c levels at baseline were significantly higher in patients who developed CIN than those in non-CIN group (0.65±0.08 versus 0.58±0.1; P = 0.001). The multivariate logistic regression showed that cyt c was an independent risk factor for the occurrence of CIN (OR, 7.421; 95% CI, 6.471-20.741; P = 0.034) after adjusting for age, history of hypertension and diabetes mellitus, levels of creatinine, uric acid, and glucose. The ROC curve analysis showed that the area under the curve of cyt c was 0.697 (95% CI, 0.611-0.783; P = 0.001), and cyt c > 0.605 ng/mL predicted CIN with sensitivity of 79.3% and specificity of 56.9%.
Our results show that a higher cyt c level was significantly associated with the occurrence of CIN after PCI in STEMI patients. This study has been registered in the Chinese Clinical Trial Registry. The clinical trial registration number is ChiCTR1800019368.
在接受经皮冠状动脉介入治疗（PCI）的 ST 段抬高型心肌梗死（STEMI）患者中，对比剂诱导的肾病（CIN）是一种相对罕见的并发症。然而，关于细胞色素 c（cyt c）与 CIN 风险增加之间的关系知之甚少。我们进行这项研究是为了探讨血清 cyt c 对 CIN 发生的影响。
我们前瞻性地检测了 240 例 STEMI 患者行 PCI 前的 cyt c 水平。采用逻辑回归分析确定 CIN 发生的独立危险因素。采用受试者工作特征（ROC）曲线分析评估 cyt c 对 CIN 发生的预测价值。
240 例患者中有 29 例（12.1%）在 PCI 后发生 CIN。发生 CIN 的患者基线时的 cyt c 水平明显高于非 CIN 组（0.65±0.08 比 0.58±0.1；P=0.001）。多变量逻辑回归显示，在调整年龄、高血压和糖尿病病史、肌酐、尿酸和血糖水平后，cyt c 是 CIN 发生的独立危险因素（OR，7.421；95%CI，6.471-20.741；P=0.034）。ROC 曲线分析显示，cyt c 的曲线下面积为 0.697（95%CI，0.611-0.783；P=0.001），cyt c＞0.605 ng/mL 预测 CIN 的敏感性为 79.3%，特异性为 56.9%。
我们的研究结果表明，STEMI 患者 PCI 后 cyt c 水平升高与 CIN 的发生显著相关。本研究已在中国临床试验注册中心注册，临床试验注册号为 ChiCTR1800019368。
