Chen Hongwu, Yu Xiaofan, Ma Likun
Department of Cardiology, Division of Life Sciences and Medicine, The First Affiliated Hospital of the University of Science and Technology of China (USTC), USTC, Hefei, Anhui 230001, P.R. China.
Anhui Institute of Cardiovascular Diseases, Hefei, Anhui 230001, P.R. China.
Exp Ther Med. 2021 Feb;21(2):140. doi: 10.3892/etm.2020.9572. Epub 2020 Dec 14.
Risk factors associated with the development of contrast-induced nephropathy (CIN) remain poorly defined in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). The present study was designed to assess the association between the Killip grade and the development of CIN in patients with STEMI and pump failure undergoing PCI. Data were retrospectively collected from the records of patients with STEMI and pump failure from the Chinese Society of Cardiology and American Heart Association database. A total of 7,471 patients were analyzed, including 5,521 patients with Killip grade II, 878 with Killip III and 1,072 with Killip IV pump failure. Patients were classified into two groups: Those undergoing primary PCI (PPCI; n=5,063) and those undergoing elective PCI (EPCI; n=2,408). Patients in the PPCI group had higher cardiac arrest rates, lower blood pressure and higher cholesterol levels as compared to the EPCI group. There was a statistically significant difference in the rates of CIN with Killip II pump failure in the PPCI group as compared to the EPCI group, but not in those with Killip III and VI pump failure. Logistic regression analysis indicated that the Killip classification is a risk predictor for post-PCI CIN. The present results indicated a positive association between the Killip grade and post-PCI CIN in patients with STEMI and pump failure. In addition, patients with STEMI and Killip grade II pump failure were at a higher risk of PCI after PPCI as compared to EPCI. Further prospective studies are required to confirm the present results.
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，与造影剂肾病（CIN）发生相关的危险因素仍未明确界定。本研究旨在评估Killip分级与接受PCI的STEMI合并泵衰竭患者发生CIN之间的关联。数据来自中国心脏学会和美国心脏协会数据库中STEMI合并泵衰竭患者的记录，进行回顾性收集。共分析了7471例患者，其中Killip II级患者5521例，Killip III级患者878例，Killip IV级泵衰竭患者1072例。患者分为两组：接受直接PCI（PPCI；n = 5063）的患者和接受择期PCI（EPCI；n = 2408）的患者。与EPCI组相比，PPCI组患者的心脏骤停发生率更高、血压更低且胆固醇水平更高。PPCI组中Killip II级泵衰竭患者的CIN发生率与EPCI组相比有统计学显著差异，但Killip III级和IV级泵衰竭患者则无差异。逻辑回归分析表明，Killip分级是PCI术后CIN的风险预测指标。目前的结果表明，Killip分级与STEMI合并泵衰竭患者PCI术后CIN之间呈正相关。此外，与EPCI相比，STEMI合并Killip II级泵衰竭的患者在PPCI后发生PCI相关风险更高。需要进一步的前瞻性研究来证实目前的结果。
