Relationship between contrast media-induced nephropathy and CANLPH score in patients with ST-segment elevation myocardial infarction

Year 2023, , 130 - 137, 27.03.2023

Ozlem Ozcan Celebi , Birsen Doğanay

https://doi.org/10.38053/acmj.1249896

Abstract

Aim: Contrast-induced nephropathy (CIN), a significant complication of percutaneous coronary intervention (PCI), is related to increased morbidity and mortality. It has been suggested that inflammation plays an important role in the development of CIN. This study aimed to investigate the prognostic role of the CANLPH score, a new indicator of inflammation, in predicting CIN and in-hospital mortality among patients with ST-segment elevation myocardial infarction (STEMI) undergoing PCI.
Material and Method: This retrospective study included 1475 patients with STEMI undergoing PCI. CIN was defined as a 25% or 0.5 mg/dL increase in serum creatinine compared to the baseline value within 48 h after PCI. The preprocedural modified Mehran score was calculated for each patient. The CANLPH score was derived from the cut-off points of the platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, and platelet/hemoglobin ratio to predict CIN.
Results: The mean age of the patients was 62.0±14.3 years and the majority were male (69.8%). The incidence of CIN was determined as 11.5%. Multivariable regression analysis showed that increased CANLPH score (OR=4.49, p<0.001) and increased modified Mehran score (OR=1.27, p<0.001) were independent predictors of CIN. The threshold value of the CANLPH score in predicting CIN was >1 with 73.5% sensitivity and 78.2% specificity and it exhibited better diagnostic performance than other inflammatory indices in predicting CIN and in-hospital mortality.
Conclusion: Prior to planned PCI, the CANLPH score has superior diagnostic performance in predicting CIN and mortality, and it may guide decisions about preventive measures and treatments.

Keywords

Biomarkers, contrast-induced nephropathy, inflammation, myocardial infarction

Supporting Institution

No

ST segment yükselmeli miyokard enfarktüsü olan hastalarda kontrast maddeye bağlı nefropati ile CANLPH skoru arasındaki ilişki

Abstract

Amaç: Perkütan koroner girişimin (PCI) önemli bir komplikasyonu olan kontrast kaynaklı nefropati (CIN), artmış morbidite ve mortalite ile ilişkilidir. Enflamasyonun CIN gelişiminde önemli bir rol oynadığı ileri sürülmektedir. Bu çalışmanın amacı, PCI uygulanan ST segment yükselmeli miyokard infarktüsü (STEMI) olan hastalarda CIN ve hastane içi mortaliteyi öngörmede inflamasyonun yeni bir göstergesi olan CANLPH skorunun prognostik rolünü araştırmaktı.
Materyal ve Metot: Bu retrospektif çalışma, PCI uygulanan STEMI'li 1475 hastayı içermektedir. CIN, PKG'den sonraki 48 saat içinde başlangıç değerine kıyasla serum kreatinin değerinde %25 veya 0,5 mg/dL artış olarak tanımlandı. Her hasta için Mehran skoru hesaplandı. CANLPH skoru, CIN'i tahmin etmek için trombosit/lenfosit oranı, nötrofil/lenfosit oranı ve trombosit/hemoglobin oranının eşik değerlerinden elde edildi.
Bulgular: Hastaların ortalama yaşı 62,0 ± 14,3 yıl ve çoğunluğu erkekti (%69,8). CIN insidansı %11,5 olarak belirlendi. Çok değişkenli regresyon analizi, artan CANLPH skorunun (OR = 4,48, p < 0,001) ve artan Mehran skorunun (OR = 1,31, p < 0,001) CIN'in bağımsız belirleyicileri olduğunu gösterdi. CANLPH skorunun CIN'i öngörmedeki eşik değeri %73,5 duyarlılık ve %78,2 özgüllük ile >1 olarak belirlendi. CANLPH skoru CIN ve hastane içi mortaliteyi öngörmede diğer inflamatuar indekslerden daha iyi tanısal performans sergiledi.
Sonuç: Planlanan PCI öncesinde CANLPH skoru, CIN ve mortaliteyi öngörmede üstün tanısal performansa sahiptir ve önleyici tedbirler ve tedavi kararları için rehberlik edebilir.

Keywords

biyobelirteç, kontrast kaynaklı nefropati, inflamasyon, miyokard enfarktüsü

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