P4612Elevated pentraxin-3 level is associated with impaired post procedural myocardial perfusion assessed by quantitative blush evaluator in patients with acute STEMI undergoing primary PCI

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Parlautan ◽  
R Sukmawan ◽  
S Dharma
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Perfusion ◽  
Class Ii ◽  
P Value ◽  
Primary Pci ◽  
Pentraxin 3 ◽  
Arbitrary Unit ◽  
Killip Class ◽  
Acute Stemi ◽  
Ptx3 Level

Abstract Background Long Pentraxin-3 (PTX3) has been known as an emerging cardiac biomarker and has potential diagnostic and prognostic value in coronary heart disease. Whether plasma PTX3 level is associated with post procedural myocardial perfusion assessed by quantitative blush evaluator (QuBE) in acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) is unknown. Purpose This study sought to evaluate the association between plasma PTX3 level and post procedural myocardial perfusion assessed by QuBE in patients with acute STEMI undergoing primary PCI. Methods We enrolled 217 patients with acute STEMI who underwent primary PCI (men=191, women=26). Post procedural myocardial perfusion was evaluated using QuBE. PTX3 level was measured at admission by an ELISA method. We used 0.33 ng/mL for PTX3 level as a cut off point for future worse clinical outcome as shown by previous study. Impairment of myocardial perfusion was defined as QuBE <9 arbitrary unit as also shown by previous studies. Results Plasma PTX3 level had an inverse correlation with QuBE score (r=−0.64, p<0.001). Patients in elevated PTX3 group (≥0.33 ng/mL; N=80) had lower median QuBE score compared with lower PTX3 group (<0.33ng/mL; N=137), with QuBE score (8.6 arbitrary unit vs. 15.1 arbitrary unit, P<0.001). Multivariate logistic analysis showed that plasma PTX3 level ≥0.33 ng/mL (OR=7.65, p<0.001) along with Diabetes Mellitus (OR=2.30, p=0.04), and Killip class II-IV (OR=2.57, p=0.04) were independent predictors of impaired myocardial perfusion, as shown by QuBE score <9 arbitrary unit. Analysis between PTX3 and low QuBE score Variables Multivariate OR (95% CI) P value PTX3 ≥0.33 ng/mL 7.65 (3.37–17.36) <0.001 Diabetes Mellitus 2.30 (1.01–5.23) 0.04 Hypertension 1.15 (0.47–2.82) 0.75 Killip class II-IV 2.57 (1.04–6.35) 0.04 IRA LAD 3.79 (1.64–8.78) 0.002 Thrombus grade 4 & 5 3.36 (1.06–11.98) 0.04 Post PPCI TIMI flow <3 5.29 (2.09–13.36) 0.001 PTX3, pentraxin-3; QuBE, quantitative blush evaluator; IRA, infarct related artery. Conclusions Patients with acute STEMI with high plasma PTX3 level were associated with reduced myocardial perfusion after primary PCI shown by low QuBE score. Elevated PTX3 level may be used as a marker for persistent impairment of myocardial perfusion after primary PCI in STEMI

Comparison between preoperative loading dose with Ticagrelor and Clopidogrel on myocardial perfusion during intervention in patients with STsegment elevation myocardial infarction undergoing primary percutaneous coronary intervention

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
T Sallam ◽  
E Fakhry ◽  
A El Mahmoudy ◽  
A El Etriby
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Perfusion ◽  
Statistical Significance ◽  
Hospital Death ◽  
Loading Dose ◽  
Primary Pci ◽  
Cardiac Events ◽  
Timi Flow Grade ◽  
Acute Stemi ◽  
Timi Flow

Abstract Aim and Objectives The aim of this study is to compare between clopidogrel and ticagrelor loading doses used prior to primary PCI in patients presenting with acute STEMI (ST-elevation Myocardial Infarction) on myocardial perfusion and in-hospital MACE (major adverse cardiac events). Patients and Methods The study included 170 patients who presented with acute STEMI to the cardiology department of Ain Shams university hospitals and underwent primary PCI. They were divided into 2 groups where the1st group 85 patients received clopidogrel loading dose (600mg) and the 2nd group 85 patients received ticagrelor loading dose (180mg). Post interventional thrombolysis in myocardial infarction (TIMI) flow grade and myocardial blush grade (MBG) were recorded. Results The majority of patients in both groups had the LAD as the culprit vessel for their presentation (71.8% in the clopidogrel group and 50.6% in ticagrelor group). In the clopidogrel group there were 4 patients with TIMI I flow and MBG I, 13 with TIMI II flow and MBG II and 68 with TIMI III flow and MBG III. Meanwhile in the ticagrelor group there was 2 patients with TIMI I flow and MBG I, s with TIMI II flow and MBG II and 81 with TIMI III flow and MBG III. There was no statistical significance between the two groups regarding in-hospital death of all causes and stroke after primary PCI. Conclusion Ticagrelor loading before primary PCI resulted in improved TIMI flow, MBG but did not decrease incidence of in-hospital MACE.

SUPPORTIVE EDUCATIVE SYSTEM DALAM MENINGKATKAN KEMANDIRIAN MERAWAT KAKI PADA PASIEN DIABETES MELLITUS TIPE II

2019 ◽  
Vol 9 (2) ◽  
pp. 63-72
Author(s):  
Nova Nurwinda Sari ◽  
Herlina Herlina
Keyword(s):  
Diabetes Mellitus ◽  
Health Center ◽  
Intervention Group ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Type Ii ◽  
Foot Care ◽  
Control Group Design ◽  
Patients With Diabetes

Diabetes mellitus dapat menyebabkan cukup banyak komplikasi seperti kelainan mata, kelainan ginjal, kelainan pembuluh darah dan kelainan pada kaki. Penderita diabetes mellitus yang mengalami komplikasi kronis perlu diberikan upaya preventif untuk mencegah komplikasi, salah satunya adalah kemampuan perawatan kaki. Penelitian ini dilakukan untuk menguji efektivitas supportive educative system dalam meningkatkan kemandirian perawatan kaki pada pasien dengan diabetes mellitus Tipe II di Puskesmas Permata Sukarame, Bandar Lampung. Penelitian ini menggunakan metode quasy eksperimen dengan desain pretest-posttest with control group dengan total masing-masing kelompok sebanyak 18 responden. Pengumpulan data dilakukan dengan menyebarkan kuesioner kepada responden yang memenuhi kriteria inklusi penelitian. Penelitian ini diuji menggunakan analisis univariat, bivariat dan uji T-test. Hasil penelitian menunjukkan bahwa terdapat perbedaan rata-rata dalam kemandirian perawatan kaki pada kelompok intervensi dan kelompok kontrol dengan p-value 0,000. Pendidikan dan praktik perawatan kaki harus diberikan sejak dini sebagai upaya pencegahan untuk komplikasi.   Kata kunci : Supportive educative system, kemandirian perawatan kaki   SUPPORTIVE EDUCATIVE SYSTEM IN IMPROVING INDEPENDENCE OF FOOT CARE IN PATIENTS WITH DIABETES MELLITUS TYPE II   ABSTRACT Diabetes mellitus can cause quite a lot of complications such as eye disorders, kidney disorders, vascular disorders and abnormalities in the legs. Patients with diabetes mellitus who have chronic complications need to be given a preventive effort to prevent complications, one of which is foot care ability. This research was conducted to examine the effectiveness of supportive educative systems in increasing the independence of foot care in patients with Type II diabetes mellitus in the Permata Sukarame Health Center Bandar Lampung Working Area. This study used a quasi-experimental method with pretest-posttest with control group design with a total of 18 respondents each. Data collection is done by distributing questionnaires to respondents who meet the research inclusion criteria. This study was tested using univariate, bivariate, T-Test analysis. The results showed that the mean differences in the independence of foot care in the intervention group and the control group in the Permata Sukarame Community Health Center work area with a p-value of 0,000. Education and practice of foot care should be given early as a preventative effort for complications.   Keywords: Supportive educative system, independence of foot care

EFEKTIVITAS PERAWATAN ULKUS DIABETIKUM TERHADAP PENERIMAAN DIRI PASIEN DIABETES MELITUS TIPE II DI ASRI WOUND CARE CENTRE MEDAN

2019 ◽  
Vol 4 (2) ◽  
pp. 178
Author(s):  
Elis Anggeria ◽  
Patimah Sari Siregar
Keyword(s):  
Diabetes Mellitus ◽  
Type Ii Diabetes ◽  
Wound Care ◽  
Type Ii Diabetes Mellitus ◽  
P Value ◽  
Type Ii ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers ◽  
Self Acceptance ◽  
Ulcer Treatment

<p><em>Diabetes mellitus (DM) is a group of metabolic diseases characterized by high levels of glucose in the blood (hyperglycemia) that occurs due to impaired insulin secretion, decreased insulin action, or a result of both. Self-acceptance is the ability and desire of individuals to live with all the characteristics themselves against diabetes mellitus. This study aims to determine the effectiveness of diabetic ulcer treatment on self-acceptance of Type II Diabetes Mellitus patients at Asri Wound Care Center Medan. This study uses quantitative research methods with a quasi-experimental design through the one-group pretest-posttest design approach. The population in the study as many as 20 people, with sampling techniques using saturated sampling, the research sample amounted to 20 people. This study uses a nonparametric statistical test that is paired t-test. The results of research on self-acceptance of patients with type II diabetes mellitus before treatment of diabetic ulcers showed that the majority of self-acceptance was not good, and the self-acceptance of patients after treatment of diabetic ulcers obtained the majority of good self-acceptance. The effectiveness of diabetic ulcer treatment on self-acceptance of type II diabetes mellitus patients obtained significance value p-value = 0.00 (p-value &lt;0.05) then H0 was rejected. This means that there are differences in self-acceptance of type II Diabetes mellitus patients before and after diabetic ulcer treatment at Asri Wound Care Center Medan. Future researchers are expected to discuss more deeply about the factors that affect the self-acceptance of diabetes mellitus patients who are undergoing treatment for diabetic ulcers.</em></p>

HUBUNGAN ANTARA PERAWATAN KAKI DENGAN RISIKO ULKUS KAKI DIABETES DI RUANG RAWAT INAP RSU KABUPATEN TANGERANG

Jurnal JKFT ◽  
2017 ◽  
Vol 1 (2) ◽  
pp. 8
Author(s):  
Imas Yoyoh ◽  
Imam Mutaqqijn ◽  
Nurjanah Nurjanah
Keyword(s):  
Diabetes Mellitus ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Purposive Sampling

Diabetes mellitus (DM) merupakan salah satu penyakit kronik yang terus menerus mengalami peningkatan jumlah yang signifikan dari tahun ke tahun. Komplikasi jangka panjang dari DM baik mikrovaskular dan makrovaskular dapat menyebabkan insufiensi aliran darah ke tungkai, yang dapat berujung pada infeksi, ulkus dan berakhir pada amputasi. Tujuan penelitian adalah mengetahui hubungan perawatan kaki dengan risiko ulkus kaki diabetes di Ruang Rawat Inap RSU Kabupaten Tangerang. Desain penelitian ini adalah analitik korelasi dengan menggunakan pendekatan Cross Sectional dengan jumlah sampel 54 responden, pengambilan sampel menggunakan purposive sampling. Metode pengumpulan data menggunakan kuesioner yang berisi pertanyaan tentang perawatan kaki dan lembar observasi tentang risiko ulkus kaki diabetes. Uji analisis data menggunakan uji Chi-square. Hasil penelitian sebanyak 54 responden didapatkan data kategori perawatan kaki baik dengan risiko ulkus rendah sebanyak 14 responden (58,3%). Sedangkan kategori perawatan kaki kurang baik dengan risiko ulkus tinggi sebanyak 21 responden (70,0%). Hasil analisis diperoleh nilai OR = 3,267 artinya perawatan kaki yang kurang baik mempunyai peluang 3,267 kali untuk risiko tinggi ulkus. Hasil uji statistik menggunakan Chi-Square diperoleh p=0,036 dimana nilai p-value < 0,05, maka Ho ditolak artinya terdapat hubungan antara perawatan kaki dengan risiko ulkus kaki diabetes di Ruang Rawat Inap RSU Kabupaten Tangerang. Pasien DM dengan perawatan kaki yang kurang baik berpeluang untuk terjadinya risiko ulkus tinggi dibandingkan dengan pasien DM yang perawatan kakinya baik. 

Pengaruh Konsumsi Gula Pasir Dan Gula Aren Terhadap Kadar Gula Dalam Darah Pada Penderita Diabetes Millitus Di Desa Bulokarto Kecamatan Gadingrejo Kabupaten Pringsewu Tahun 2010

2012 ◽  
Vol 1 (1) ◽  
Author(s):  
Nur Fadhilah
Keyword(s):  
Diabetes Mellitus ◽  
P Value ◽  
Diabetes Melitus

Diabetes saat ini menjadi penyakit yang mulai menjangkiti penduduk di Negara-negara berkembang seperti Indonesia. World Healt Organitation (WHO) memperkirakan pada tahun 2030 nanti sekitar 21,3 juta orang Indonesia terkena diabetes. Tujuan penelitiari ini adalah untuk mengetahui perbedaan pengaruh konsumsigula pasir dan gula aren terhadap kadar gula darah pada diabetes melitus Di Desa Bulokarto Kecamatan Gatling Rejo Kabupaten Pringsewu Tahun 2010. Penelitian ini dilakukan dengan metode quasi eksperiment dengan sampel 44 penderita diabetes. Sampel diambil dengan teknik i7>tal sampling dengan cara acak dibagi dalam dua kelompok eksperiment, yaitu kelompok gula pasir dan kelompok gula aren. Pengaruh gula pasir dan gula aren didapat dengan menggunakan uji T dependent dan uji T i,1dependent.Distribusi rata - rata perubahan kadar gula pada kelompok gula aren 25,56 mg/dl dengan standar deviasi 11,74 mg/dL Sedangkan perubahan kadar gula darah pada kelompok gula pasir didapat rata - rata 45,80 mg/dl dengan standar deviasi 14,92 mg/dl. Dengan p value 0.00 maka dapat disimpulkan bahwa terdapat perbedaan selisih peningkatan kadar gula yang signifikan antara konsumsi gula pasir dan gula aren terhadap kadar gula darah pada penderita diabetes mellitus di Desa Bulokarto Kecamatan Gadingrejo Kabupaten Pringsewu. Diharapkan penderita diabetes mellitus dapat mengganti pengunaan gula pasir dengan gula aren.

Assessment of Admission Time Cell Blood Count (CBC) Parameters in Predicting Post-primary Percutaneous Coronary Intervention TIMI Frame Count in Patients with ST-segment Elevation Myocardial Infarction

2020 ◽  
Vol 20 (3) ◽  
pp. 191-197
Author(s):  
Hossein Vakili ◽  
Isa Khaheshi ◽  
Amirsina Sharifi ◽  
Negin Nickdoost ◽  
Mohammad H. Namazi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Platelet Count ◽  
P Value ◽  
Primary Pci ◽  
Blood Samples ◽  
Timi Frame Count ◽  
Admission Time ◽  
No Reflow ◽  
Corrected Timi Frame Count ◽  
No Reflow Phenomenon

Objectives: In this study, we aimed to assess the value of admission time CBC parameters in predicting post-primary PCI corrected TIMI frame count. Background: Recent years have witnessed a large series of studies evaluating different laboratory variables to predict no-reflow phenomenon following primary PCI (PPCI) in patients with STEMI. However, a general agreement about the most reliable predictor of the no-reflow phenomenon is challenging and also intriguing. Methods: The current study concluded 208 consecutive patients who underwent primary PCI for ST-Elevation Myocardial Infarction (STEMI) from January 2014 to February 2016. Blood samples were obtained after taking ECG. Complete blood samples were collected and analyzed within 5 minutes from sampling. Post-PCI corrected Thrombolysis in Myocardial Infarction (TIMI) frame count was determined by one interventional cardiologist blinded to patients’ clinical data. The correlation between admission time blood parameters and post-primary PCI corrected TIMI frame count in patients with STEMI were assessed. Results: Corrected TIMI frame count was positively correlated with WBC count (R: 0.18, P-value: <0.01), neutrophil count (R: 0.34, P-value: <0.01), and platelet count (R: 0.23, P-value: <0.01) and negatively correlated with lymphocyte count (R: -0.2, P-value: <0.01). Multiple linear regression results demonstrated that corrected TIMI frame count was positively correlated with neutrophil count (P < 0·001) and platelet count (P < 0·001) and negatively correlated with lymphocyte count (p=0.004). Conclusion: High counts of WBC, neutrophil, and platelet and low count of lymphocyte may be predictors of no-reflow in STEMI patients undergoing PPCI. The clinical significance of such predictive parameters becomes clear as we consider the treatment approach in STEMI patients. Appropriate risk stratification leads to better treatment planning and allocation of resources.

Association Between Awareness of Informal Caregivers and Falls in Elderly Patients with Uncontrolled Diabetes Mellitus

2020 ◽  
Vol 13 (1) ◽  
pp. 658-666
Author(s):  
Tossapon Chamnankit ◽  
Parichat Ong-artborirak ◽  
Jukkrit Wangrath
Keyword(s):  
Diabetes Mellitus ◽  
Elderly Patients ◽  
Elderly People ◽  
Informal Caregivers ◽  
Multivariable Analysis ◽  
P Value ◽  
Uncontrolled Diabetes ◽  
Risk Of Falls ◽  
The Mean ◽  
Falls In Elderly

Background: Elderly people with uncontrolled diabetes mellitus (DM) are at risk of falls, which can lead to injury and disability. Not much is known of informal caregivers’ awareness of falls in elderly patients with DM. Objective: This study aims to identify an association between caregiver’s awareness and falls in elderly patients with DM. Methods: A total of 136 pairs of DM patients and their respective family caregivers were recruited from a clinical service center at Chiang Mai University, Thailand. The questionnaire regarding the caregiver’s awareness of the risk of falls in elderly patients was given via a face-to-face interview. Each elderly patient was asked about their history of falls in the prior year, and the risk of falls was assessed by Time Up & Go (TUG) test. Logistic regression analysis was performed to determine association. Results: The mean age of the DM patients was 65.7 years. Sixty-two patients (45.6%) had fallen at least once in the prior year. The mean TUG test result was 12.67±1.83 second. Most caregivers demonstrated a high level of awareness regarding the risk of falls in elderly patients. The results of the multivariable analysis showed that three variables – balance problems, risk of falls assessed by TUG test, and scores of caregiver’s awareness of risk of falls – were significantly related to falls in the previous year among elderly patients with DM (p-value<0.05). Conclusion: The caregivers’ awareness of fall risk may influence fall occurrence among older adults with DM. An intervention program to improve awareness among informal caregivers should be considered for fall prevention in elderly people.

Self Management Menentukan Kualitas Hidup Pasien Diabetes Mellitus

2019 ◽  
Vol 4 (2) ◽  
pp. 402
Author(s):  
Iskim Luthfa ◽  
Nurul Fadhilah
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Correlation Study ◽  
Self Management ◽  
Rank Test ◽  
P Value ◽  
Cross Sectional ◽  
Spearman Rank ◽  
Consecutive Sampling

<p><em>People with diabetes mellitus are at risk of developing complications, so that it affects the quality of life. These complications can be minimized through self-care management. This study aims to determine the relationship between self management with the quality of life for people with diabetes mellitus. This research is a kind of quantitative research with correlation study. This research used cross sectional design. The sampling technique uses non probability with estimation consecutive sampling. The number of respondents in this research are 118 respondents. Instrument for measuring self management used diabetes self management questionnaire (DSMQ), and instruments to measure quality of life used quality of life WHOQOL-BREEF. The data obtained were processed statistically by using spearman rank test formula and p value of 0,000 There is a significant relationship of self management with the quality of life of people with diabetes mellitus.</em></p><p> </p><p><em>Penderita </em><em>Diabetes mellitus </em><em>beresiko mengalami komplikasi yang dapat mempengaruhi kualitas hidupnya. Komplikasi tersebut dapat diminimalkan melalui manajemen perawatan diri (self management). Penelitian ini bert</em><em>ujuan </em><em>untuk</em><em> menganalisis hubungan self management dengan kualitas hidup pasien diabetes melitus. </em><em>Jenis p</em><em>enelitian ini </em><em>adalah</em><em> deskriptif korelasi</em><em> dengan desain cross sectional</em><em>. Teknik pengambilan sampel menggunakan non probability </em><em>sampling </em><em>dengan pendeka</em><em>t</em><em>an consecutive sampling</em><em>.</em><em> </em><em>J</em><em>umlah </em><em>sampel sebanyak</em><em> </em><em>118 responden.</em><em> </em><em>Instrumen </em><em>penelitian </em><em>untuk mengukur self management </em><em>menggunakan</em><em> </em><em>diabetes self management questionnaire</em><em> (DSMQ), </em><em>dan instrumen untuk mengukur kualitas hidup menggunakan </em><em>quality of life </em><em>WHOQOL-BREEF.</em><em> Analisis data menggunakan spearman rank dan didapatkan hasil nilai </em><em>p value 0,000</em><em> dan r 0,394.Terdapat </em><em>hubungan </em><em>antara </em><em>self management</em><em> dengan kualitas hidup pasien diabetes mellitus</em><em> dengan arah korelasi positif.</em></p>

scholarly journals Environmental Cadmium Exposure and Dental Indices in Orthodontic Patients

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 413
Author(s):  
Hui-Ling Chen ◽  
Jason Chen-Chieh Fang ◽  
Chia-Jung Chang ◽  
Ti-Feng Wu ◽  
I-Kuan Wang ◽  
...  
Keyword(s):  
Cadmium Concentration ◽  
Class Ii ◽  
Cadmium Exposure ◽  
Class I ◽  
P Value ◽  
Tooth Decay ◽  
Class Iii ◽  
Orthodontic Patients ◽  
Urine Cadmium ◽  
The Mean

Background. Previous studies have shown that environmental cadmium exposure could disrupt salivary gland function and is associated with dental caries and reduced bone density. Therefore, this cross-sectional study attempted to determine whether tooth decay with tooth loss following cadmium exposure is associated with some dental or skeletal traits such as malocclusions, sagittal skeletal pattern, and tooth decay. Methods. Between August 2019 and June 2020, 60 orthodontic patients with no history of previous orthodontics, functional appliances, or surgical treatment were examined. The patients were stratified into two groups according to their urine cadmium concentrations: high (>1.06 µg/g creatinine, n = 28) or low (<1.06 µg/g creatinine, n = 32). Results. The patients were 25.07 ± 4.33 years old, and most were female (female/male: 51/9 or 85%). The skeletal relationship was mainly Class I (48.3%), followed by Class II (35.0%) and Class III (16.7%). Class I molar relationships were found in 46.7% of these patients, Class II molar relationships were found in 15%, and Class III molar relationships were found in 38.3%. The mean decayed, missing, and filled surface (DMFS) score was 8.05 ± 5.54, including 2.03 ± 3.11 for the decayed index, 0.58 ± 1.17 for the missing index, and 5.52 ± 3.92 for the filled index. The mean index of complexity outcome and need (ICON) score was 53.35 ± 9.01. The facial patterns of these patients were within the average low margin (26.65 ± 5.53 for Frankfort–mandibular plane angle (FMA)). There were no significant differences in the above-mentioned dental indices between patients with high urine cadmium concentrations and those with low urine cadmium concentrations. Patients were further stratified into low (<27, n = 34), average (27–34, n = 23), and high (>34, n = 3) FMA groups. There were no statistically significant differences in the urine cadmium concentration among the three groups. Nevertheless, a marginally significant p-value of 0.05 for urine cadmium concentration was noted between patients with low FMA and patients with high FMA. Conclusion. This analysis found no association between environmental cadmium exposure and dental indices in our orthodontic patients.

scholarly journals A simple nomogram to predict contrast-induced acute kidney injury in patients with congestive heart failure undergoing coronary angiography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Lei ◽  
Y He ◽  
Z Guo ◽  
B Liu ◽  
J Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Acute Kidney Injury ◽  
Coronary Angiography ◽  
Prediction Models ◽  
Validation Cohort ◽  
Kidney Injury ◽  
Class Ii ◽  
Functional Class ◽  
Killip Class

Abstract Background Patients with congestive heart failure (CHF) are vulnerable to contrast-induced acute kidney injury (CI-AKI), but few prediction models are currently available. Objectives We aimed to establish a simple nomogram for CI-AKI risk assessment for patients with CHF undergoing coronary angiography. Methods A total of 1876 consecutive patients with CHF (defined as New York Heart Association functional class II-IV or Killip class II-IV) were enrolled and randomly (2:1) assigned to a development cohort and a validation cohort. The endpoint was CI-AKI defined as serum creatinine elevation of ≥0.3 mg/dL or 50% from baseline within the first 48–72 hours following the procedure. Predictors for the nomogram were selected by multivariable logistic regression with a stepwise approach. The discriminative power was assessed using the area under the receiver operating characteristic (ROC) curve and was compared with the classic Mehran score in the validation cohort. Calibration was assessed using the Hosmer–Lemeshow test and 1000 bootstrap samples. Results The incidence of CI-AKI was 9.06% (n=170) in the total sample, 8.64% (n=109) in the development cohort and 9.92% (n=61) in the validation cohort (p=0.367). The simple nomogram including four predictors (age, intra-aortic balloon pump, acute myocardial infarction and chronic kidney disease) demonstrated a similar predictive power as the Mehran score (area under the curve: 0.80 vs 0.75, p=0.061), as well as a well-fitted calibration curve. Conclusions The present simple nomogram including four predictors is a simple and reliable tool to identify CHF patients at risk of CI-AKI, whereas further external validations are needed. Figure 1 Funding Acknowledgement Type of funding source: None

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