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炎症性预后指数对行冠状动脉造影和/或经皮冠状动脉介入治疗的患者对比剂肾病的预测价值。

Predictive value of inflammatory prognostic index for contrast-induced nephropathy in patients undergoing coronary angiography and/or percutaneous coronary intervention.

机构信息

School of Nursing, Fujian Medical University, Fuzhou, Fujian, China.

Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.

出版信息

Sci Rep. 2024 Jul 9;14(1):15861. doi: 10.1038/s41598-024-66880-7.

Abstract

The purpose of this study was to investigate the relationship between Inflammatory Prognostic Index (IPI) levels and Contrast-Induced Nephropathy (CIN) risk and postoperative clinical outcomes in patients undergoing coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). A total of 3,340 consecutive patients who underwent CAG and/or PCI between May 2017 and December 2022 were enrolled in this study. Based on their baseline IPI levels, patients were categorized into four groups. Clinical characteristics and postoperative outcomes were compared among these groups. In-hospital outcomes focused on CIN risk, repeated revascularization, major bleeding, and major adverse cardiovascular events (MACEs), while the long-term outcome examined the all-cause readmission rate. Quartile analysis found a significant link between IPI levels and CIN risk, notably in the highest quartile (P < 0.001). Even after adjusting for baseline factors, this association remained significant, with an adjusted Odds Ratio (aOR) of 2.33 (95%CI 1.50-3.64; P = 0.001). Notably, baseline IPI level emerged as an independent predictor of severe arrhythmia, with aOR of 0.50 (95%CI 0.35-0.69; P < 0.001), particularly driven by the highest quartile. Furthermore, a significant correlation between IPI and acute myocardial infarction was observed (P < 0.001), which remained significant post-adjustment. For patients undergoing CAG and/or PCI, baseline IPI levels can independently predict clinical prognosis. As a comprehensive inflammation indicator, IPI effectively identifies high-risk patients post-procedure. This study underscores IPI's potential to assist medical professionals in making more precise clinical decisions, ultimately reducing mortality and readmission rates linked to cardiovascular disease (CVD).

摘要

本研究旨在探讨炎症预后指数(IPI)水平与接受冠状动脉造影(CAG)和/或经皮冠状动脉介入治疗(PCI)的患者对比剂诱导肾病(CIN)风险和术后临床结局之间的关系。共纳入 2017 年 5 月至 2022 年 12 月期间接受 CAG 和/或 PCI 的 3340 例连续患者。根据其基线 IPI 水平,将患者分为四组。比较这些组之间的临床特征和术后结局。住院期间结局主要关注 CIN 风险、再次血运重建、大出血和主要不良心血管事件(MACEs),而长期结局则检查全因再入院率。四分位分析发现 IPI 水平与 CIN 风险之间存在显著关联,尤其是在最高四分位(P<0.001)。即使在校正基线因素后,这种关联仍然显著,调整后的优势比(aOR)为 2.33(95%CI 1.50-3.64;P=0.001)。值得注意的是,基线 IPI 水平是严重心律失常的独立预测因子,aOR 为 0.50(95%CI 0.35-0.69;P<0.001),特别是最高四分位。此外,还观察到 IPI 与急性心肌梗死之间存在显著相关性(P<0.001),校正后仍然显著。对于接受 CAG 和/或 PCI 的患者,基线 IPI 水平可独立预测临床预后。作为一种全面的炎症指标,IPI 可以有效地识别术后高风险患者。本研究强调了 IPI 有助于医疗专业人员做出更精确的临床决策,从而降低与心血管疾病(CVD)相关的死亡率和再入院率的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e017/11233516/599674491c72/41598_2024_66880_Fig1_HTML.jpg

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