Yeni Yuzyil University, Faculdade de Medicina, Departamento de Cardiologia, Istambul - Turquia.
Arq Bras Cardiol. 2021 Jun;116(6):1048-1056. doi: 10.36660/abc.20200172.
Contrast-induced nephropathy (CIN) is associated with an increased risk of major adverse cardiovascular events (MACE), and the association between CIN and oxidative mechanisms is well documented.
This study aimed to evaluate the relationship between serum levels of kidney injury molecule-1 (KIM-1) and CIN in elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI).
This study included a total of 758 patients with NSTEMI, who underwent percutaneous coronary intervention (PCI); 15 developed CIN after PCI, and another 104 were the control group, matched for age > 65 years. Baseline to 48-to-72-hour laboratory values and clinical outcomes were recorded. Patients were followed during one year. P values of < 0.05 were considered significant.
CIN was observed in 12.60% of the patients. Serum KIM-1 was significantly higher in the CIN group than in the non-CIN group (14.02 [9.53 - 19.90] vs. 5.41 [3.41 - 9.03], p < 0.001). The Mehran score was significantly higher in the CIN group than in the non-CIN group (14 [5 - 22] vs. 5 [2 - 7], p = 0.001). MACE were significantly higher in the CIN group than in the non-CIN group (7 [46.70%] vs. 12 [11.50%], p = 0.001). Multivariate logistic regression analysis showed that baseline KIM-1 level (OR = 1.652, 95% CI: 1.20 - 2.27, p = 0.002) and Mehran score (OR = 1.457, 95% CI: 1.01 - 2.08, p = 0.039) were independent predictors of CIN in elderly patients with NSTEMI.
Baseline serum KIM-1 concentration and Mehran score are independent predictors of CIN in elderly patients with NSTEMI. Additionally, all-cause mortality, cardiovascular death, myocardial reinfarction, stroke, and MACE were significantly higher in the CIN group at one-year follow-up. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0).
对比剂诱导的肾病（CIN）与主要不良心血管事件（MACE）的风险增加相关，并且 CIN 与氧化机制之间的关联已得到充分证实。
本研究旨在评估老年非 ST 段抬高型心肌梗死（NSTEMI）患者中血清肾损伤分子 1（KIM-1）水平与 CIN 之间的关系。
本研究共纳入 758 例接受经皮冠状动脉介入治疗（PCI）的 NSTEMI 患者，其中 15 例在 PCI 后发生 CIN，另 104 例为年龄>65 岁的对照组。记录基线至 48-72 小时的实验室值和临床结果。患者在一年内接受随访。P 值<0.05 被认为具有统计学意义。
CIN 发生率为 12.60%。CIN 组患者的血清 KIM-1 水平明显高于非 CIN 组（14.02[9.53-19.90]比 5.41[3.41-9.03]，p<0.001）。CIN 组的 Mehran 评分明显高于非 CIN 组（14[5-22]比 5[2-7]，p=0.001）。CIN 组的主要不良心血管事件（MACE）发生率明显高于非 CIN 组（7[46.70%]比 12[11.50%]，p=0.001）。多变量逻辑回归分析显示，基线 KIM-1 水平（OR=1.652，95%CI：1.20-2.27，p=0.002）和 Mehran 评分（OR=1.457，95%CI：1.01-2.08，p=0.039）是老年 NSTEMI 患者发生 CIN 的独立预测因素。
老年 NSTEMI 患者的基线血清 KIM-1 浓度和 Mehran 评分是 CIN 的独立预测因素。此外，在 1 年随访时，CIN 组的全因死亡率、心血管死亡、心肌再梗死、卒中和 MACE 发生率明显更高。
