Low level of high-density lipoprotein cholesterol predicts contrast induced-acute kidney injury after percutaneous coronary interventions in patients with coronary heart disease
10.3760/cma.j.issn.1671-0282.2014.09.016
- VernacularTitle:低水平高密度脂蛋白胆固醇是经皮冠脉介入术后急性肾损伤的危险因素
- Author:
Yongli CHEN
;
Jing XU
;
Yuanyuan LIU
;
Shicheng YANG
;
Hongliang CONG
;
Naikuan FU
- Publication Type:Journal Article
- Keywords:
High-density lipoprotein cholesterol;
Percuta neous coronary intervention;
Acute kidney injury;
Contrast
- From:
Chinese Journal of Emergency Medicine
2014;23(9):1018-1022
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship of low level of high-density lipoprotein cholesterol to contrast induced-acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI) in patients with coronary heart disease.Methods A total of 1500 consecutive patients,who underwent PCI from January 2009 to May 2011,were enrolled in this study.There was no limit on age or sex,and all patients were self-identified as Han ethnic group.Patients were excluded from this study,however,if they had a history of malignant tumor,urinary tract infection,nephrectomy operation,chronic peritoneal or hemodialysis,or if they had been exposed to contrast media within the past 14 days.CI-AKI was defined as an absolute increase in serum creatinine ≥44.2 μmol/L or a relative ≥25％ increase in serum creatinine within 72 hours after procedure.Low level of HDL-C was defined as ＜ 1.04 mmol/L.Monofactorial and multivariate analysis was performed to identify risk factors for CI-AKI and low level of HDL-C in these patients.Results Among the 1500 patients with coronary heart disease,CI-AKI occurred in 246 patients after PCI and the overall incidence of CI-AKI was 16.4％.The patients with low level of HDL-C had a higher incidence of CI-AKI than those without it (21.5％ vs.13.3％ in total,P ＜0.01),no matter that they had suffered from chronic kidney disease (39.8％ vs.26.5％,P ＜ 0.05) or not (17.7％ vs.9.7％,P ＜ 0.01).By multivariate analysis,low level of HDL-C was identified as an independent risk factor for CI-AKI and smoke,great BMI as well as anemia were considered as prediction factors for low level of HDL-C.Conclusion The patients with low level of HDL-C have a higher incidence of CI-AKI after PCI.Low level of HDL-C is one of risk factors for CI-AKI after PCI in patients either with chronic kidney disease or not.Great BMI,smoking as well as anemia are independent predictors for low HDL-C level in these patients.
