Al-Mosawi Mohammed, Mousa Bashar Abed, Almohana Sadiq, Hadi Najah R
AL-SADRE TEACHING HOSPITAL, NAJAF, IRAQ.
DEPARTMENT OF NEPHROLOGY AND RENAL TRANSPLANT CENTRE, AL-SADER TEACHING HOSPITAL, NAJAF, IRAQ.
Wiad Lek. 2022;75(12):3010-3017. doi: 10.36740/WLek202212120.
The aim: A serious and common complication after percutaneous coronary intervention is acute kidney injury, which is associated with an increased risk of renal, cardiovascular and even mortality; therefore, early prognosis and identification of patients at higher risk are essential for early initiation of preventive measures. The aim of this study is to predict and compare the risk for the development of CI-AKI in patient with ACS who undergo emergency PCI or elective (i.e. after medical stabilization) PCI by utilizing the sensitivity of serum NGAL as an early and reliable predictor for CI-AK.
Materials and methods: The study include 37 patients with acute coronary syndrome, baseline serum creatinine, complete blood count and pre and two hours post operative serum neutrophil gelatinase-associated lipocalin were measured and all patients underwent percutaneous coronary intervention according to the standard protocol used in Al Najaf Cardiac Center.
Results: This is a Two-Arm study that included a total of 37 patients with acute coronary syndrome aged 38-83 years. Eighteen of them had emergency percutaneous coronary intervention while the remaining 19 had elective percutaneous coronary intervention (after medical stabilization). Elevation of serum neutrophil gelatinase-associated lipocalin level two hours after percutaneous coronary intervention was found to be significantly higher among emergency percutaneous coronary intervention group compared to elective group.
Conclusions: Acute coronary syndrome patients are undergoing emergency percutaneous coronary intervention are at an increasing risk for the development of contrast induced acute kidney injury than those undergoing elective percutaneous coronary intervention.
经皮冠状动脉介入治疗后一种严重且常见的并发症是急性肾损伤，它与肾脏、心血管甚至死亡风险增加相关；因此，早期预后评估及识别高危患者对于尽早启动预防措施至关重要。本研究的目的是通过利用血清中性粒细胞明胶酶相关脂质运载蛋白作为对比剂诱导的急性肾损伤（CI-AKI）的早期可靠预测指标的敏感性，预测并比较接受急诊经皮冠状动脉介入治疗（PCI）或择期（即药物稳定后）PCI的急性冠状动脉综合征（ACS）患者发生CI-AKI的风险。
本研究纳入37例急性冠状动脉综合征患者，测量其基线血清肌酐、全血细胞计数以及术前和术后两小时的血清中性粒细胞明胶酶相关脂质运载蛋白水平，所有患者均按照纳杰夫心脏中心使用的标准方案接受经皮冠状动脉介入治疗。
这是一项双臂研究，共纳入37例年龄在38至83岁的急性冠状动脉综合征患者。其中18例接受急诊经皮冠状动脉介入治疗，其余19例接受择期经皮冠状动脉介入治疗（药物稳定后）。结果发现，与择期组相比，急诊经皮冠状动脉介入治疗组在经皮冠状动脉介入治疗两小时后血清中性粒细胞明胶酶相关脂质运载蛋白水平升高更为显著。
结论：与接受择期经皮冠状动脉介入治疗的患者相比，接受急诊经皮冠状动脉介入治疗的急性冠状动脉综合征患者发生对比剂诱导的急性肾损伤的风险更高。
