scholarly journals Fibrinogen-to-Albumin Ratio Predicts Contrast-Induced Nephropathy in Patients after Emergency Percutaneous Coronary Intervention

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Zhebin You ◽  
Tailin Guo ◽  
Fan Lin ◽  
Chunjin Lin ◽  
Jiankang Chen ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Serum Creatinine ◽  
Coronary Intervention ◽  
Contrast Induced Nephropathy ◽  
Baseline Serum ◽  
Albumin Ratio ◽  
Logistic Analysis ◽  
Percutaneous Coronary ◽  
Emergency Percutaneous Coronary Intervention ◽  
Multivariate Logistic Analysis

Background. The aim of the present study was to investigate the association between fibrinogen-to-albumin ratio (FAR) with contrast-induced nephropathy (CIN) in patients undergoing emergency percutaneous coronary intervention (PCI). Methods. 565 patients with emergency PCI were consecutively enrolled. The primary outcome was CIN defined as either a 25% increase in baseline serum creatinine levels or a 0.5 mg/dL (44 μmol/L) increase in absolute serum creatinine levels within 72 h after the contrast medium exposure. Logistic regression analysis was applied to analyze whether FAR was an independent risk factor for CIN. Results. Overall, 29 (5.1%) patients developed CIN. Compared with the patients without CIN, the patients developing CIN had lower albumin (39.79 ± 3.95 vs. 37.14 ± 5.21, P=0.012) and higher fibrinogen levels (3.51 ± 0.94 vs. 4.14 ± 0.96, P<0.001). In the multivariate logistic analysis, FAR was an independent predictor of CIN (OR = 3.97; 95% CI, 1.61–9.80; P=0.003) along with perihypotension, age >75 years, and LVEF <45%, and 0.106 was the optimal cutoff value of preprocedural FAR to predict CIN. Conclusion. Preprocedural levels of FAR were associated with CIN in patients after emergency PCI.

Preventive effect of trimetazidine on contrast-induced nephropathy undergoing percutaneous coronary intervention in elderly moderate and high risk diabetics stratified by mehran score

Perfusion ◽  
2020 ◽  
pp. 026765912095205
Author(s):  
Xue Zhang ◽  
Peng Zhang ◽  
Shicheng Yang ◽  
Wenyuan Li ◽  
Xiuzhen Men ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Serum Creatinine ◽  
Coronary Intervention ◽  
Low Risk ◽  
Control Group ◽  
Preventive Effect ◽  
Contrast Induced Nephropathy ◽  
Risk Population ◽  
Percutaneous Coronary

Background: The aim of this research was to use the Mehran risk score to classify elderly diabetics with coronary heart disease to assess the preventive effect of trimetazidine on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in different risk population. Methods: An uncompromised of 760 elderly diabetics that went through PCI were included in this research. The patients were first divided into three groups in the light of MRS: low-risk, moderate-risk, and high-risk group, then randomized into trimetazidine group and the control group respectively. The first endpoint was the amount of CIN, which is described as a rise in serum creatinine levels by ⩾44.2 μmol/L or ⩾25% ratio within 48 or 72 hours after medication. Second endpoint included differences in creatinine clearance rate (CrCl), blood urea nitrogen (BUN), serum creatinine (Scr), cystatin-C (Cys-C), and the incidence of major adverse events after administration. Results: In the three groups, the incidence of CIN in trimetazidine and control group was 5.0% versus 4.9%(χ2 = 0.005, p > 0.05), 8.0% versus 18.0% (χ2 = 7.685, p < 0.05), 10.4% versus 27.1% (χ2 = 4.376, p < 0.05), respectively. The multivariable logistic regression result demonstrated that trimetazidine intervention was a profitable element of CIN in moderate and high-risk groups (OR = 0.294, 95% CI 0.094-0.920, p = 0.035). Conclusion: Our study confirmed that trimetazidine can be considered for preventive treatment of CIN occurrence in elderly diabetics with moderate and high-risk population, while there is no obvious advantage compared with hydration therapy in low-risk patients.

scholarly journals CHA2DS2-VAS-HSF Score as a Predictor for Contrast- Induced Nephropathy in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention

2019 ◽  
Vol 39 (2) ◽  
Author(s):  
Herman William Parlindungan ◽  
Refli Hasan ◽  
Cut Aryla Andra ◽  
Nizam Zikri Akbar ◽  
Ali Nafiah Nasution ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Serum Creatinine ◽  
Coronary Revascularization ◽  
Coronary Intervention ◽  
Long Term Outcomes ◽  
Contrast Induced Nephropathy ◽  
Coronary Syndrome ◽  
Major Cardiovascular Events ◽  
Percutaneous Coronary

Background: Contrast-Induced Nephropathy (CIN) is a serious problem that can be found in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). The development of CIN in hospitalized patients even with coronary revascularization can immediately increase morbidity and mortality both during treatment and long-term outcomes. In a recent study, a CHA2DS2-VASC-HSF score was reported to predict coronary artery severity and major cardiovascular events (MACE) as well as CIN in AMI patients without atrial fibrillation. The purpose of this study was to investigate the CHA2DS2-VASC score as a predictor of CIN in AMI patients undergoing PCI procedures. Methods: This study was an ambispective cohort study of 53 AMI patients who were treated at cardiac care and underwent PCI procedures. The CHA2DS2-VASC-HSF score was calculated for each patient. From this study found 14 cases (26.4%) with a total CIN prevalence of 16.83%. CIN is defined as an increase in serum creatinine> 0.5 mg / dL or an increase in serum creatinine> 25% from baseline within 24 hours post PCI. Results: Through the analysis of the ROC curve, we established the CHA2DS2- VASC-HSF score cut point> 5 as a predictor of CIN with a sensitivity of 78.57% and specificity of 66.6 %% (AUC 0.818, 95%: CI 3.018-6.142, p <0.001). By getting the equation from the linear regression assessment we also found the probability of the occurrence of CIN in accordance with the CHA2DS2-VASC-HSF score. Conclusion: CHA2DS2-VASC score has a positive correlation with CIN. Therefore, this score can be used as a simple scoring system and can predict the incidence of CIN in AMI patients undergoing PCI procedures.

scholarly journals Association between Platelet-to-Lymphocyte Ratio and Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome

2015 ◽  
Vol 5 (2) ◽  
pp. 96-104 ◽  
Author(s):  
Muhammed Bora Demircelik ◽  
Alparslan Kurtul ◽  
Hakan Ocek ◽  
Muzaffer Cakmak ◽  
Cagın Ureyen ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Serum Creatinine ◽  
Coronary Intervention ◽  
Platelet To Lymphocyte Ratio ◽  
Contrast Induced Nephropathy ◽  
Lymphocyte Ratio ◽  
Coronary Syndrome ◽  
Inflammatory Conditions ◽  
Percutaneous Coronary

Objective: Contrast-induced nephropathy (CIN) is associated with significantly increased morbidity and mortality after percutaneous coronary intervention (PCI). Patients with acute coronary syndrome (ACS) are at higher risk of CIN. The platelet-to-lymphocyte ratio (PLR) is closely linked to inflammatory conditions. We hypothesized that PLR levels on admission can predict the development of CIN after PCI for ACS. Subjects and Methods: A total of 426 patients (mean age 63.17 ± 13.01 years, 61.2% males) with ACS undergoing PCI were enrolled in this study. Admission PLR levels were measured before PCI. Serum creatinine values were measured before and within 72 h after the administration of contrast agents. Patients were divided into 2 groups: the CIN group and the no-CIN group. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dl or 25% above baseline within 72 h after contrast administration. Results: CIN developed in 53 patients (15.9%). Baseline PLR was significantly higher in patients who developed CIN compared to those who did not (160.8 ± 29.7 and 135.1 ± 26.1, respectively; p < 0.001). Multivariate analyses found that PLR [odds ratio (OR) 3.453, 95% confidence interval (CI) 1.453-8.543; p = 0.004] and admission creatinine (OR 6.511, 95% CI 1.759-11.095; p = 0.002) were independent predictors of CIN. Conclusions: The admission PLR level is an independent predictor of the development of CIN after PCI in ACS.

scholarly journals Reduced glutathione does not further reduce contrast-induced nephropathy in elderly patients with diabetes receiving percutaneous coronary intervention

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096401
Author(s):  
Lingqing Wang ◽  
Enguo Xu ◽  
Shijia Ren ◽  
Xingjian Gu ◽  
Jiping Zheng ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Treatment Group ◽  
Elderly Patients ◽  
Serum Creatinine ◽  
Reduced Glutathione ◽  
Coronary Intervention ◽  
Occurrence Rate ◽  
Contrast Induced Nephropathy ◽  
Percutaneous Coronary ◽  
Patients With Diabetes

Objective To investigate the preventive effect of hydration combined with reduced glutathione on contrast-induced nephropathy (CIN) after coronary intervention therapy in elderly Chinese patients with diabetes. Methods Patients with diabetes aged ≥65 years, who received percutaneous coronary intervention (PCI) between 1 August 2016 and 31 December 2018, were enrolled and randomized into two groups: patients treated with hydration combined with reduced glutathione (treatment group) and patients who received hydration alone (controls). Serum creatinine and creatinine clearance levels were measured in all patients before PCI and then daily for 3 days after PCI. Occurrence of CIN (the primary endpoint) was defined as serum creatinine value 25% or 44.2 mmol/l (0.5 mg/dl) above baseline at 72 h after an exposure to contrast medium. Results A total of 396 patients were included (treatment group, n = 204; and controls, n = 192). The CIN occurrence rate in the treatment and control group was 5.88% and 6.77%, respectively, with no statistically significant between-group difference. Conclusion In elderly patients with diabetes receiving PCI, the risk of CIN was not effectively lowered by hydration combined with reduced glutathione.

P6532Trimetazidine and nicorandil decrease the increment of serum creatinine in patients with normal or slightly decreased renal function after undergoing elective percutaneous coronary intervention

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
X Li ◽  
X Wang ◽  
D Liu ◽  
M Zhang ◽  
M Liu ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Renal Function ◽  
Serum Creatinine ◽  
Protective Effect ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Control Group ◽  
Contrast Induced Nephropathy ◽  
P Values ◽  
Percutaneous Coronary

Abstract Background Contrast-induced nephropathy (CIN) is a serious complication of percutaneous coronary intervention which can cause serious adverse outcomes. There is still no effective treatment for it. Aims To evaluate and compare the protective effect of trimetazidine and nicorandil on renal function in patients undergoing percutaneous coronary intervention.with estimated glomerular filtration (eGFR) >60 ml/min/1.7 m2. Method 161 patients who met the inclusion criteria were recruited and divided into control group (n=41), trimetazidine group (n=40), nicorandil group (n=40) and trimetazidine combined with nicorandil group (n=40). Both TMZ and nicorandil were administered orally 72 hours before and 48 hours after the procedure. All patients in the four groups were given intravenous saline (0.9%) at a rate of 1 ml/kg/h 6 hours before and 12 hours after the procedure. Serum creatinine (SCr), GFR were measured before and 48 hours after the procedure. An increase of 44mmol/L (0.5mg/dL) in SCr or 25% higher than basal levels at 48 hours after administered iodinated CM was diagnosed as CIN. Results (1) The baseline characteristics of the four groups were similar. (2) The SCr levels increased in control group (baseline 73.07±15.69 VS. after PCI 91.71±23.10 mmol/L), TMZ group (baseline 71.90±17.30 VS. after PCI 82.00±17.19 mmol/L), nicorandil group (baseline 72.23±15.95 VS. after PCI 81.45±18.30 mmol/L)and TMZ plus nicorandil group (baseline 71.13±13.50 VS. after PCI 73.35±12.64 mmol/L) at 48 hours after the procedure, all p values <0.05. (3) The increment of SCr after PCI in control group (ΔScr=18.63±9.21 mmol/L) is higher than TMZ group (ΔScr=10.10±5.62 mmol/L) and nicorandil group (ΔScr=9.23±5.60mmol/L), and is higher than TMZ plus nicorandil group (ΔScr=2.23±1.42 mmol/L), all p values <0.001. There was no statistical difference of increment of SCr between TMZ group and nicorandil group. (4) Contrast-induced nephropathy developed in 14.6% (6/41) in control group, 2.5% (1/40) in TMZ group and 2.5% (1/40) in nicorandil group (p<0.05), none in TMZ plus nicorandil group. Conclusions TMZ and nicorandil exerted similar protective effect on renal function by decreasing SCr level and CIN incidence after PCI. The efficacy of TMZ combined with nicorandil on renal protection was greater than TMZ or nicorandil alone.

Impact of Low Hemoglobin on Contrast-Induced Nephropathy After Percutaneous Coronary Intervention

2012 ◽  
Vol 5 (1) ◽  
pp. 30-36
Author(s):  
M Akhtaruzzaman ◽  
AK Choudhury ◽  
M Khalequzzaman ◽  
SK Barua ◽  
TA Choudhury ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Clearance Rate ◽  
Coronary Intervention ◽  
Serum Electrolytes ◽  
Contrast Induced Nephropathy ◽  
Creatinine Clearance Rate ◽  
Group I ◽  
Percutaneous Coronary

Background: Contrast-Induced Nephropathy (CIN) is an iatrogenic disorder, resulting from exposure to contrast media. The aim of this study was to assess whether anaemia is a predictor of contrast induced nephropathy after Percutaneous Coronary Intervention (PCI). Methods: This was a prospective observational study. A total of one hundred patients fulfilling the inclusion and exclusion criteria who underwent (PCI) Percutaneous Transluminal Coronary Angioplasty with stenting, were studied during the study period of two years from January 2008 to December 2009. Patients were divided into two groups : Group-I (n=50), patients with low hemoglobin (male <13-10gm/dl, female < 12-10 gm/dl) and Group-II (n=50), patients with normal hemoglobin (male ?13gm/dl, female ?12gm/dl). Non-ionic low-osmolar contrast agents was used in all patients.Volume of contrast medium (ml) was recorded. Adequate hydration given intravenously (ml). Prior to procedure serum creatinine, serum electrolytes and Creatinine clearance rate were measured within 24 hrs before PCI and on days 1,2,3 after PCI. If there is renal impairment (CIN) serum creatinine, serum electrolytes and Creatinine clearance rate were measured daily from the 4th day onward after PCI until recovery. Results: The mean serum creatinine level of low hemoglobin group and normal hemoglobin group were 0.9mg/dl and 1mg/dl respectively at base line. The low hemoglobin group experienced a considerable increase in serum creatinine up to 1.5mg/dl at day 3 compared to 1.3 mg/dl in normal hemoglobin group. When the most common definition of contrast induced nephropathy (as an increase in the serum creatinine concentration >0.5 mg/dl from baseline) was used the incidence of CIN was 26% in low hemoglobin group and 8% in the normal hemoglobin group. Conclusion: preprocedural low hemoglobin is an independent determinant of increased incidence of contrast induced nephropathy after percutaneous coronary intervention. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12226 Cardiovasc. j. 2012; 5(1): 30-36

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