Comparison of the Relationship Between Inflammatory Markers and Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome After Coronary Angiography

Angiology ◽  
2019 ◽  
Vol 71 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Cagri Zorlu ◽  
Cemal Koseoglu
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Angiography ◽  
Independent Predictor ◽  
Coronary Intervention ◽  
Contrast Induced Nephropathy ◽  
Lymphocyte Ratio ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
The Relationship

Contrast-induced nephropathy (CIN) is one of the most important complications after invasive cardiovascular procedures. The neutrophil-to-lymphocyte ratio (NLR), mean platelet volume-to-lymphocyte ratio (MPVLR), and platelet-to-lymphocyte ratio (PLR) may be markers of the risk of CIN. We aimed to investigate the association of these indices with the development of CIN in patients with ST-elevation myocardial infarction and non-ST-elevation-acute coronary syndrome who underwent percutaneous coronary intervention. We retrospectively collected the data of patients with ACS after coronary angiography (CA); 564 patients were included (mean age, 62.3 ± 13.0 years; 41.1% female). We compared 62 (10.9%) patients who developed CIN and 502 patients who did not, after CA in terms of NLR, PLR, and MPVLR. Patients who developed CIN had significantly higher MPVLR, NLR, and PLR; the MPVLR ( P ≤ .001) was an independent predictor of CIN. NLR, MPVLR, and PLR are simple, cheap, and easily accessible tests that can predict CIN; the MPVLR was the strongest of these predictors.

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.

Abstract 12873: Blood Transfusion and the Risk of Contrast-Induced Nephropathy Among Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Wassef Karrowni ◽  
Amit N Vora ◽  
Dadi Dai ◽  
Daniel Wojdyla ◽  
Habib Dakik ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Blood Transfusion ◽  
Primary Outcome ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Contrast Induced Nephropathy ◽  
Coronary Syndrome ◽  
Post Procedure ◽  
Lower Baseline ◽  
Percutaneous Coronary

Introduction: Emerging scientific and clinical evidence suggests that blood transfusion might be risk factor for acute kidney injury. Hypothesis: Blood transfusion is independently associated with contrast-induced nephropathy (CIN) in acute coronary syndrome (ACS) patients undergoing PCI. Methods: Retrospective cohort study from the NCDR CathPCI Registry (2009-2014) (n=1,756,864). Primary outcome was CIN defined as rise in serum creatinine peak post-procedure ≥ 0.5 mg/dl or ≥ 25% above baseline. Results: CIN developed in 9.0% of the cohort; these patients were older (66.0 vs. 64.0 years; P<0.01), more often female (43.2% vs. 31.9%; P<0.01), and had more baseline comorbidities including DM (46.1%), hypertension (85.1%), and lower baseline GFR. Blood transfusion was utilized in 38,626 (2.2%) of patients. The adjusted OR for the risk of CIN with transfusion in the overall sample, patients with major bleeding, and patients with no bleeding were 4.87 (4.71-5.04), 2.21 (2.12-2.31), and 4.80 (4.40 - 5.24) respectively (Table). Association of CIN with transfusion was significantly increased across all pre-procedure hemoglobin (Hgb) levels and in stepwise fashion with increasing Hgb levels and regardless of post-procedure bleeding (Hgb &lt=10: adjusted OR (95%CI) 2.90 (2.75-3.05); Hgb &gt10 to &lt=13: 5.26 (5.06-5.48); Hgb &gt13 to &lt=15: 6.37 (5.99-6.78); Hgb &gt15 g/dl: 7.03 (6.43-7.67); Ptrend <0.01). Conclusions: Blood transfusion is strongly associated with CIN in ACS patients undergoing PCI. Whether a restrictive blood transfusion strategy lowers the risk of contrast nephropathy should be investigated.

On-ticagrelor platelet reactivity and clinical outcome in patients undergoing percutaneous coronary intervention for acute coronary syndrome

2020 ◽  
Author(s):  
marc laine ◽  
Vassili PANAGIDES ◽  
Corinne Frère ◽  
thomas cuisset ◽  
Caroline Gouarne ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Clinical Outcome ◽  
Platelet Reactivity ◽  
Coronary Intervention ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
The Relationship

Background: A strong association between on-thienopyridines platelet reactivity (PR) and the risk of both thrombotic and bleeding events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) has been demonstrated. However, no study has analyzed the relationship between on-ticagrelor PR and clinical outcome in this clinical setting. Objectives: We aimed to investigate the relationship between on-ticagrelor PR, assessed by the vasodilator-stimulated phosphoprotein (VASP) index, and clinical outcome in patients with ACS undergoing PCI. Methods: We performed a prospective, multicenter, observational study of patients undergoing PCI for ACS. PR was measured using the VASP index following ticagrelor loading dose. The primary study endpoint was the rate of Bleeding Academic Research Consortium (BARC) type ≥2 at 1 year. The key secondary endpoint was the rate of major cardiovascular events (MACE) defined as the composite of cardiovascular death, myocardial infarction and urgent revascularization. Results: We included 570 ACS patients, among whom 33.9% had ST-elevation myocardial infarction. BARC type ≥ 2 bleeding occurred in 10.9% and MACE in 13.8%. PR was not associated with BARC ≥ 2 or with MACE (p=0.12 and p=0.56, respectively). No relationship between PR and outcomes was observed, neither when PR was analyzed quantitatively nor qualitatively (low on-treatment PR (LTPR) vs no LTPR). Conclusion: On-ticagrelor PR measured by the VASP was not associated with bleeding or thrombotic events in ACS patients undergoing PCI. PR measured by the VASP should not be used as a surrogate endpoint in studies on ticagrelor.

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