Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.
Sci Rep. 2020 Feb 25;10(1):3365. doi: 10.1038/s41598-020-60359-x.
Prevention for contrast-induced nephropathy (CIN) is limited by the lack of a single predictor. As activin A is upregulated in heart failure and chronic kidney disease, we aimed to clarify the association between activin A levels and renal outcomes after coronary angiography (CAG). This prospective observational study included 267 patients who received CAG between 2009 and 2015. CIN was defined as elevation of serum creatinine to >0.5 mg/dL or to >25% above baseline within 48 hours after CAG. During follow-up, laboratory parameters were measured every 3-6 months. Renal decline was defined as>2-fold increase in serum creatinine or initiation of dialysis. The patients were stratified into tertiles according to serum activin A levels at baseline. High activin A tertile was significantly associated more CIN and renal function decline compared to low activin A tertile (all p < 0.001). After adjusting potential confounding factors, high serum activin A tertiles was associated to CIN (Odds ratio 4.49, 95% CI 1.07-18.86, p = 0.040) and renal function decline (Hazard ratio 4.49, 95% CI 1.27-11.41, p = 0.017) after CAG.
对比剂诱导肾病（CIN）的预防受到缺乏单一预测因子的限制。由于激活素 A 在心力衰竭和慢性肾脏病中上调，我们旨在阐明激活素 A 水平与冠状动脉造影（CAG）后肾脏结局之间的关系。这项前瞻性观察性研究纳入了 2009 年至 2015 年间接受 CAG 的 267 名患者。CIN 的定义为 CAG 后 48 小时内血清肌酐升高至>0.5mg/dL 或比基线升高>25%。在随访期间，每 3-6 个月测量实验室参数。肾功能下降定义为血清肌酐升高>2 倍或开始透析。根据基线时的血清激活素 A 水平，患者被分为三分位。与低激活素 A 三分位相比，高激活素 A 三分位与更多的 CIN 和肾功能下降显著相关（均 p<0.001）。在调整潜在混杂因素后，高血清激活素 A 三分位与 CIN（优势比 4.49，95%置信区间 1.07-18.86，p=0.040）和 CAG 后肾功能下降（危险比 4.49，95%置信区间 1.27-11.41，p=0.017）相关。
