ST Elevasyonlu Miyokart İnfarktüsü Hastalarında Serum Ozmolaritesinin Kontrast Nefropatisi Üzerine Etkisi

Year 2019, Volume: 22 Issue: 3, 157 - 161, 24.12.2019

Serkan Kahraman , Hicaz Zencirkıran

Abstract

Giriş: Kontrast ilişkili nefropati (KİN) ST elevasyonlu miyokart infarktüsü (STEMİ) hastalarında artmış mortalitenin en önemli nedenlerinden birisidir. Çalışmamızda perkütan koroner girişim uygulanan STEMİ hastalarında serum ozmolaritesinin KİN üzerine etkisini incelemeyi amaçladık.

Hastalar ve Yöntem: STEMİ olan 163 ardışık hasta çalışmaya dahil edildi. Ardından hastalar KİN gelişmeyen grup 1 ve gelişen grup 2 olarak ikiye ayrıldı. Bazal klinik, serum ozmolaritesini içeren laboratuvar ve demografik özellikler her iki grupta karşılaştırıldı.

Bulgular: Yüz kırk dört KİN olmayan hasta grup 1, yirmi iki KİN olan hasta grup 2 olarak alındı. Serum ozmolaritesi KİN gelişen hastalarda daha yüskek saptandı [289.06 (284.75-292.39), 291.71 (289.69-295.72); p= 0.004]. Ayrıca yaş (OR: 1.097, CI: 1.033-1.164; p= 0.002) ve serum ozmolaritesi (OR: 1.117, CI: 1.008- 1.238; p= 0.035) KİN’in bağımsız öngördürücüleri olarak saptandı.

Sonuç: Artmış serum ozmolaritesi perkütan koroner girişim uygulanan STEMİ hastalarında KİN ile ilişkilidir. Bu ilişki koroner arter hastalığı tedavi edilse bile artmış kötü klinik sonlanımlardan sorumlu olabilir.

The Impact of Serum Osmolarity on Contrast-Induced Nephropathy in Patients with ST-Segment Elevation Myocardial Infarction

Abstract

Introduction: Contrast-induced nephropathy (CIN) is one of the most important causes for increased mortality rates in ST-segment elevation myocardial infarction (STEMI) patients. In our study, we aimed to investigate the impact of serum osmolarity on CIN in patients with STMEI who were undergoing percutaneous coronary intervention.

Patients and Methods: A total of 163 consecutive patients with STEMI were enrolled in this study. The patients were divided into two groups; patients without CIN were assigned to group 1 and patients with CIN were assigned to group 2. The baseline clinical, laboratory and demographic features, including the serum osmolarity, were compared for both groups.

Results: A total of 144 patients without CIN comprised group 1, while 22 patients with CIN comprised group 2. The serum osmolarity level [289.06 (284.75-292.39), 291.71 (289.69-295.72); p= 0.004] was higher in patients with CIN. Additionally, age (OR: 1.097, CI: 1.033-1.164; p= 0.002) and serum osmolarity (OR:1.117, CI: 1.008-1.238; p= 0.035) were found to be independent predictors of CIN.

Conclusion: Higher serum osmolarity is related with CIN in STEMI patients who are undergoing percutaneous coronary intervention. This could cause increased adverse clinical outcomes, even if the underlying coronary artery disease is treated successfully.

Keywords

Contrast-induced nephropathy, serum osmolarity, STEMI

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