Department of Cardiology, Erciyes University Medicine Faculty, Kayseri, Turkey.
Department of Cardiology, Kayseri City Hospital, Kayseri, Turkey.
Scand J Clin Lab Invest. 2021 May;81(3):173-180. doi: 10.1080/00365513.2021.1878386. Epub 2021 Feb 2.
This study aimed to evaluate thiol disulphide volume for the risk of contrast-induced nephropathy CIN) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).
A total of 638 patients with ACS were enrolled in the study. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dL or ≥25% above baseline within 72 h after the procedure. Patients were divided into two groups: patients with and without CIN. Demographics, clinical risk factors, angiographic and laboratory parameters, CIN incidence, thiol, disulphide, and CHA2DS2-VASc score were compared between the two groups.
Native thiol, total thiol, and disulphide at baseline were significantly lower in patients who developed CIN compared to those who did not. Also, the CHA2DS2-VASc score was found to be higher in patients with CIN than those without CIN. In receiver operating characteristic analysis showed that at a cutoff of <342.1, the value of native thiol exhibited 82% sensitivity and 80% specificity for detecting CIN. Total thiol< 383.1 calculated on admission had an 80% sensitivity and 80% specificity in predicting CIN.
Our study suggested that the thiol disulphide volume on admission was independently associated with the development of CIN after PCI in patients with ACS.
本研究旨在评估急性冠脉综合征（ACS）经皮冠状动脉介入治疗（PCI）患者的巯基-二硫键体积与对比剂诱导的肾病（CIN）的风险。
共纳入 638 例 ACS 患者。CIN 定义为术后 72 小时内血清肌酐水平升高≥0.5mg/dL 或较基线升高≥25%。患者分为两组：CIN 组和非 CIN 组。比较两组患者的人口统计学、临床危险因素、血管造影和实验室参数、CIN 发生率、巯基、二硫键和 CHA2DS2-VASc 评分。
与未发生 CIN 的患者相比，发生 CIN 的患者的基础状态巯基、总巯基和二硫键明显降低。而且，CIN 组患者的 CHA2DS2-VASc 评分高于非 CIN 组患者。在受试者工作特征分析中，当截断值<342.1 时，基础巯基的价值对检测 CIN 的灵敏度为 82%，特异性为 80%。入院时计算的总巯基<383.1 对预测 CIN 的灵敏度为 80%，特异性为 80%。
本研究表明，ACS 患者 PCI 后 CIN 的发生与入院时巯基-二硫键体积独立相关。
