Shemirani Hasan, Hosseini Ali
Cardiology Department, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute and Chamran Cardiovascular and Medical Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Chamran Cardiovascular and Medical Research Hospital and Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2024 Jan 30;29:5. doi: 10.4103/jrms.jrms_136_21. eCollection 2024.
Contrast-induced nephropathy (CIN) is associated with increased mortality and morbidity in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention. This study aimed to compare the incidence of CIN in two groups of patients with and without metabolic syndrome (Mets) with baseline normal renal function.
In this case - control study, 260 patient candidates for CAG, 130 patients with Mets and 130 patients without Mets participated, and their serum creatinine (Cr) level before and the 48 and 72 h after the angiography was measured. The incidence of CIN was compared in two groups. Two-way analysis of variance with repeated measures and univariate and multivariate logistic regression models.
The results showed a higher chance of being Mets with raising in triglyceride (adjusted odds ratio = 1.05, 95% confidence interval = (1.03-1.06), < 0.001), Fasting blood glucose (1.010 [1.001-1.019], = 0.025), and diastolic blood pressure (1.07 [1.07-1.20], < 0.001), but declining in high-density lipoprotein-cholesterol (HDL-C) (0.91 [0.85-0.98], = 0.008). Furthermore, blood urea nitrogen (BUN) and Cr level was raised in 48 and 72 h after contrast injection in both groups (All < 0.001). Furthermore, in 48 h (3.11 [1.12-9.93], = 0.016) and 72 h (2.82 [1.07-8.28], = 0.021) after injection, a total of 25 patients had an increased Cr level and a significant difference between Mets and without Mets groups. The developing Mets had a significant association with the increased risk of AKI, which increased the chance of developing nephropathy (7.14 [2.27-22.5], = 0.001).
Mets, together with other risk factors, increased the overall risk of CIN development. Therefore, the incidence of CIN in patients Mets is significantly higher than that of patients without Mets, indicating a more important CIN risk factor.
造影剂肾病（CIN）与接受冠状动脉造影（CAG）和经皮冠状动脉介入治疗的患者死亡率和发病率增加相关。本研究旨在比较两组基线肾功能正常、患有和未患有代谢综合征（Mets）的患者中CIN的发生率。
在这项病例对照研究中，260例CAG候选患者参与其中，其中130例患有Mets，130例未患有Mets，测量他们造影前、造影后48小时和72小时的血清肌酐（Cr）水平。比较两组中CIN的发生率。采用重复测量的双向方差分析以及单因素和多因素逻辑回归模型。
结果显示，随着甘油三酯升高（调整后的优势比 = 1.05，95%置信区间 =（1.03 - 1.06），P < 0.001）、空腹血糖（1.010 [1.001 - 1.019]，P = 0.025）和舒张压（1.07 [1.07 - 1.20]，P < 0.001）升高，患Mets的可能性增加，但高密度脂蛋白胆固醇（HDL - C）降低（0.91 [0.85 - 0.98]，P = 0.
