Yang Xinping, Zhang Lizi, Wei Hao, Zhang Fan, Yang Han, Shi Jiahua
Department of Anesthesiology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China.
Ren Fail. 2025 Dec;47(1):2532859. doi: 10.1080/0886022X.2025.2532859. Epub 2025 Jul 29.
Acute kidney injury (AKI) commonly complicates coronary revascularization, worsening outcomes. Estimated pulse wave velocity (ePWV), a simple arterial stiffness marker, independently predicts cardiovascular risk. This study aimed to evaluate the association between ePWV and AKI in patients undergoing coronary revascularization. Based on the Medical Information Mart for Intensive Care (MIMIC)-IV database, this retrospective cohort study obtained the data of patients who underwent coronary revascularization, including percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). The ePWV was calculated based on the patients' age and blood pressure. Univariable and multivariable logistics regression were utilized to evaluate the association between ePWV and AKI in this population, with odds ratio (ORs) and 95% confidence intervals (CIs). Stratified analyses based on age, gender, surgery types, complications were further conducted to verify this association. This study ultimately included 2,842 eligible patients who underwent coronary revascularization. Among them, 1,174 (41.31%) occurred AKI. We observed high ePWV is associated with high risk of AKI in patients received coronary revascularization (OR = 1.36, 95%CI: 1.10-1.69). Similar results were also observed in patients who underwent CABG (OR = 1.08, 95%CI: 0.96-1.21), without the history of acute myocardial infarction (OR = 1.39, 95%CI: 1.06-1.82), or atrial fibrillation (OR = 1.36, 95%CI: 1.07-1.73), or with the history of hypertension (OR = 1.48, 95%CI: 1.12-1.95) or had higher estimated glomerular filtration rate (eGFR) level (OR = 1.45, 95%CI: 1.16-1.81). The results suggested high ePWV is associated with the high risk of AKI among patients underwent coronary revascularization. The ePWV is a simple and noninvasive indicator that could be used for risk stratification of AKI after coronary revascularization.
急性肾损伤（AKI）常使冠状动脉血运重建复杂化，导致预后恶化。估计脉搏波速度（ePWV）是一种简单的动脉僵硬度标志物，可独立预测心血管风险。本研究旨在评估接受冠状动脉血运重建患者中ePWV与AKI之间的关联。基于重症监护医学信息集市（MIMIC）-IV数据库，这项回顾性队列研究获取了接受冠状动脉血运重建患者的数据，包括经皮冠状动脉介入治疗（PCI）和冠状动脉旁路移植术（CABG）。ePWV根据患者年龄和血压计算得出。采用单变量和多变量逻辑回归评估该人群中ePWV与AKI之间的关联，并得出比值比（OR）和95%置信区间（CI）。进一步基于年龄、性别、手术类型、并发症进行分层分析以验证这种关联。本研究最终纳入了2842例接受冠状动脉血运重建的合格患者。其中，1174例（41.31%）发生了AKI。我们观察到，在接受冠状动脉血运重建的患者中，高ePWV与AKI高风险相关（OR = 1.36，95%CI：1.10 - 1.69）。在接受CABG的患者中（OR = 1.08，95%CI：0.96 - 1.21）、无急性心肌梗死病史的患者中（OR = 1.39，95%CI：1.06 - 1.82）、无房颤的患者中（OR = 1.36，95%CI：1.07 - 1.73）、有高血压病史的患者中（OR = 1.48，95%CI：1.12 - 1.95）或估计肾小球滤过率（eGFR）水平较高的患者中（OR = 1.45，95%CI：1.16 - 1.81）也观察到了类似结果。结果表明，在接受冠状动脉血运重建的患者中，高ePWV与AKI高风险相关。ePWV是一种简单且无创的指标，可用于冠状动脉血运重建后AKI的风险分层。
