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德瑞蒂斯比值与接受急诊经皮冠状动脉介入治疗患者的造影剂相关性急性肾损伤预测及长期临床结局相关。

De Ritis Ratio is Associated with Contrast-Associated Acute Kidney Injury Prediction and Long-Term Clinical Outcomes in Patients Undergoing Emergency Percutaneous Coronary Intervention.

作者信息

Zhang Wenkang, Li Mingkang, Huang Xu, Zhang Minhao, Yan Gaoliang, Tang Chengchun

机构信息

Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China.

School of Medicine, Southeast University, Nanjing, China.

出版信息

Angiology. 2024 Nov-Dec;75(10):945-953. doi: 10.1177/00033197231190421. Epub 2023 Jul 20.

Abstract

Contrast-associated acute kidney injury (CA-AKI) is a familiar complication following percutaneous coronary intervention (PCI). The present study evaluated the predictive value of the De Ritis ratio for CA-AKI and its association with long-term clinical outcomes in patients undergoing emergency PCI. Overall, 546 patients were included in this study. The De Ritis ratio was calculated by aspartate aminotransferase/alanine aminotransferase activity. The De Ritis ratios in the CA-AKI patients were significantly higher than the non-CA-AKI patients [3.74 (2.32, 4.90) vs 1.61 (1.02, 2.53); P < .001]. The De Ritis ratio was an independent risk factor for CA-AKI [odds ratio, 2.243; 95% confidence interval (CI), 1.823-2.759; P < .001]. The area under the ROC curve was .813 (95% CI, .763-.862; P < .001), and the sensitivity and specificity were 67.0% and 82.4%, respectively, when the optimum cut-off value was 2.97. Furthermore, patients in the high De Ritis ratio group (≥1.76) had a significantly greater incidence of primary endpoints [26.7% (73/273) vs 13.2% (36/273); P < .001], and the high De Ritis ratio was an independent predictor for primary endpoints (hazard ratio, 1.888, 95% CI, 1.235-2.887; P = .003). In conclusion, the De Ritis Ratio is associated with CA-AKI prediction and long-term clinical outcomes in patients undergoing emergency PCI.

摘要

对比剂相关急性肾损伤(CA-AKI)是经皮冠状动脉介入治疗(PCI)后常见的并发症。本研究评估了De Ritis比值对CA-AKI的预测价值及其与接受急诊PCI患者长期临床结局的关联。本研究共纳入546例患者。De Ritis比值通过天冬氨酸转氨酶/丙氨酸转氨酶活性计算得出。CA-AKI患者的De Ritis比值显著高于非CA-AKI患者[3.74(2.32,4.90)vs 1.61(1.02,2.53);P <.001]。De Ritis比值是CA-AKI的独立危险因素[比值比,2.243;95%置信区间(CI),1.823 - 2.759;P <.001]。ROC曲线下面积为.813(95% CI,.763 -.862;P <.001),当最佳截断值为2.97时,敏感性和特异性分别为67.0%和82.4%。此外,高De Ritis比值组(≥1.76)患者的主要终点发生率显著更高[26.7%(73/273)vs 13.2%(36/273);P <.001],高De Ritis比值是主要终点的独立预测因素(风险比,1.888,95% CI,1.235 - 2.887;P =.003)。总之,De Ritis比值与接受急诊PCI患者的CA-AKI预测及长期临床结局相关。

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