Relationship between carbon dioxide combining power and contrast-induced acute kidney injury in patients with ST segment elevation myocardial infarction undergoing emergency percutaneous coronary intervention
10.3760/cma.j.issn.0253-3758.2014.07.006
- VernacularTitle:二氧化碳结合力与急诊冠状动脉介入治疗后对比剂性急性肾损害的关系
- Author:
Peng RAN
1
;
Junqing YANG
;
Xuxi YANG
;
Yingling ZHOU
;
Ning TAN
;
Yiting HE
;
Guang LI
;
Shuo SUN
;
Yong LIU
;
Nianjin XIE
;
Jiyan CHEN
Author Information
1. 广东省心血管病研究所 广东省医学科学院 广东省人民医院心内科
- Keywords:
Nephrosis;
Contrast media;
Angioplasty,transluminal,percutaneous coronary
- From:
Chinese Journal of Cardiology
2014;(7):551-556
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the relationship between carbon dioxide combining power ( CO2-CP) and contrast-induced acute kidney injury ( CI-AKI) in patients with ST segment elevation myocardial infarction and undergoing percutaneous coronary intervention.Methods We retrospectively analyzed 174 patients admitted to our hospital from March 2012 to August 2013 with ST segment elevation myocardial infarction and underwent emergency percutaneous coronary intervention.Patients were divided into three tertiles according to pre-operative CO2-CP: T1 (CO2-CP <22.62 mmol/L),T2(CO2-CP 22.62 -24.30 mmol/L), T3(CO2-CP>24.30 mmol/L).Baseline clinical data, CI-AKI incidence, in-hospital mortality and dialysis rate were compared among groups.An increase in serum creatinine of >26.4 μmol/L and/or >50%from baseline within 48 hours after contrast exposure was defined as CI-AKI.Univariate logistic regression analysis was used to identify the risk factors of CI-AKI.The relationship between CO 2-CP and CI-AKI was assessed by multivariate logistic regression analysis.Receiver operating characteristic curve was used to identify the optimal cutoff of the CO 2-CP for predicting CI-AKI.Results CI-AKI occurred in 25(14.4%) patients, and lower CO2-CP was related to higher incidence of CI-AKI (27.6% (16/58) in group T1, 5.3%(3/57) in group T2, 1.7 % (1/59) in group T3, P=0.002) and higher in-hospital mortality (10.3%(6/58) vs.0 and 1.7%(1/59), P=0.010).Dialysis rate was similar among 3 groups (5.2%(3/58)vs.0 and 1.7%(1/59), P=0.168).The incidence of CI-AKI was significantly associated with CO2-CP<22.00 mmol/L in univariate analyses ( OR=6.767,95%CI 2.731-16.768, P<0.001).After adjusting for potential confounding risk factors , CO2-CP <22.00 mmol/L remained significantly associated with the incidence of CI-AKI (OR=5.835,95%CI 1.800-18.914, P=0.003) in multivariate logistic regression.ROC analysis revealed that the optimal cutoff of CO 2-CP to predict CI-AKI was 22.00 mmol/L (sensitivity 64.0%,specificity 79.1%, AUC=0.714).Conclusions Pre-percutaneous coronary intervention CO 2-CP in patients with ST segment elevation myocardial infarction undergoing percutaneous coronary intervention is related to CI-AKI.CO2-CP<22.00 mmol/L predicts higher risk of CI-AKI in this patient cohort.
