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接受经皮冠状动脉介入治疗的高危患者中对比剂肾病新兴预测指标的评估

Evaluation of Emerging Predictors for Contrast-Induced Nephropathy in High-Risk Patients Undergoing Percutaneous Coronary Intervention.

作者信息

Gupta Himanshu, Singh Mohit Mohan, Sahani Krishna Kumar, Gupta Ayushi, Seth Ganesh

机构信息

Cardiology, Medanta Heart Institute, Medanta Hospital, Lucknow, IND.

Cardiology, Apollomedics Super Speciality Hospital, Lucknow, IND.

出版信息

Cureus. 2024 Jul 11;16(7):e64363. doi: 10.7759/cureus.64363. eCollection 2024 Jul.

Abstract

OBJECTIVE

The objective of this study is to investigate the occurrence and factors that influence the development of contrast-induced nephropathy (CIN) in high-risk patients undergoing angioplasty and to evaluate the effectiveness of the Mehran risk score in predicting CIN among this patient population.

MATERIALS AND METHOD

This prospective, observational study enrolled patients undergoing elective coronary angiography or a percutaneous coronary intervention (PCI) procedure. The patients were stratified into four risk groups based on the Mehran risk score, a validated tool for predicting the risk of CIN. Univariate and multivariate analyses were conducted to evaluate the risk factors associated with the development of CIN. A p-value of <0.05 was considered to indicate statistical significance.

RESULTS

During the study period, a total of 55 high-risk patients underwent PCI. The incidence of CIN was 25.5% (n=14). Univariate and multivariate analyses revealed that age >75 years and estimated glomerular filtration rate (eGFR) <60 (p<0.05) were independently associated with a significantly increased risk of developing CIN. A considerable proportion of patients (23; 41.8%) in the study were categorized as having an intermediate risk for CIN based on the Mehran risk score.

CONCLUSION

This study observed a high incidence of CIN and encourages the use of predictive tools like the Mehran risk score to assess the risk of CIN occurrence, with age over 70 years and eGFR less than 60 emerging as significant.

摘要

目的

本研究旨在调查接受血管成形术的高危患者中对比剂肾病(CIN)的发生情况及影响其发展的因素,并评估梅兰风险评分在预测该患者群体发生CIN方面的有效性。

材料与方法

这项前瞻性观察性研究纳入了接受选择性冠状动脉造影或经皮冠状动脉介入治疗(PCI)的患者。根据梅兰风险评分(一种用于预测CIN风险的有效工具),将患者分为四个风险组。进行单因素和多因素分析以评估与CIN发生相关的危险因素。p值<0.05被认为具有统计学意义。

结果

在研究期间,共有55名高危患者接受了PCI。CIN的发生率为25.5%(n = 14)。单因素和多因素分析显示,年龄>75岁和估计肾小球滤过率(eGFR)<60(p<0.05)与发生CIN的风险显著增加独立相关。根据梅兰风险评分,相当一部分患者(23例;41.8%)被归类为CIN中度风险。

结论

本研究观察到CIN的高发生率,并鼓励使用梅兰风险评分等预测工具来评估CIN发生的风险,其中年龄超过70岁和eGFR低于60被证明具有显著意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53e9/11316681/26f79701664d/cureus-0016-00000064363-i01.jpg

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