The Relationship Between Serum Urotensin II Level and Contrast-Induced Nephropathy and One-year Clinical Follow-up Findings in Patients with Coronary Slow Phenomenon Undergoing Percutaneous Coronary Intervention

Abstract

Background: Coronary slow-reflow phenomenon (CSFP) and Contrast-Induced Nephropathy (CIN) are associated with an increased risk of major cardiovascular adverse events. This study aimed to evaluate the relationship between serum Urotensin II molecule (U-II) levels and CIN in patients with CSFP undergoing percutaneous coronary intervention (PCI).

Methods: We enrolled  227  patients (161 male and 66 female; mean age: 61,44 ± 12,44 years) with angiographically diagnosed CSFP. The patients were divided into two groups according to CIN development (Non-CIN (n=206) and CIN group (n=21)).

Results: CIN was observed in 9,25%(n=21) of the CSFP patients. Serum U-II level was significantly higher in CIN group than in non-CIN group (6,79±2,2 vs. 3±1,29, p<0.001). One year clinical follow-up findings including all-cause mortality (7(33,3%) vs. 24(11,7%), p=0,013), cardiovascular death(7(33,3%) vs. 18(8,7%), p=0,003) and Major Adverse cardiovascular events (MACE) (10(47,6%) vs. 46(22,4%), p: 0,011) were significantly higher in CIN group. We also performed forward conditional logistic regression analysis and found that U-II (Odds ratio (OR)= 3,983; 95% confidence interval (CI): 2,25 to 7,052; p < 0.001) and Mehran score (OR=1,228, 95% CI: 1,083-1,393, p=0,001) were independently predicted CIN development in patients with CSFP.

Conclusions: Baseline serum U-II concentrations and higher Mehran scores are independently associated with CIN in CSFP patients. One year clinical follow-up findings including all-cause mortality, cardiovascular death and MACE were significantly higher in CIN group, but stroke and myocardial infarction rates were similar in both groups.

Keywords

• Urotensin II,Slow-Flow Phenomenon,Contrast-Induced Nephropathy,percutaneous coronary intervention,Major Adverse cardiovascular events

Perkütan Koroner Girişim Yapılan Koroner Yavaş Akım Olgularında, Serum Urotensin II Düzeyi ve Kontrast Kaynaklı Nefropati Gelişimi ile Bir Yıllık Klinik Takip Bulguları Arasındaki İlişki

Abstract

Amaç: Koroner yavaş akıntı fenomeni (CSFP) ve kontrast kaynaklı nefropati (CIN), artmış kardiyovasküler advers olay riski ile ilişkilidir. Bu çalışmada, CSFP'li perkütan koroner girişim (PCI) yapılan hastalarda serum Urotensin II molekülü (U-II) düzeyleri ile CIN arasındaki ilişkiyi değerlendirmeyi amaçladık.

Yöntem: Anjiyografik olarak CSFP tanısı alan 227 hasta (161 erkek ve 66 kadın; ort. yaş: 61,44 ± 12,44) çalışmaya alındı. Hastalar CIN gelişmesine (CIN Dışı (n = 206) ve CIN grubuna (n = 21)) göre iki gruba ayrıldı.

Bulgular: CSFP hastalarının% 9,25'inde (n = 21) CIN gözlendi. Serum U-II düzeyi CIN grubunda CIN olmayan gruba göre anlamlı derecede yüksek saptandı (6,79 ± 2,2 vs. 3 ± 1,29, p <0,001). Tüm nedenlere bağlı mortalite (7 (% 33,3) ve 24 (% 11,7), p = 0,013), kardiyovasküler ölüm (7 (% 33,3) ve 18 (8, % 7), p = 0,003) ve Majör olumsuz kardiyovasküler olaylar (MACE) (10 (% 47,6) vs. 46 (% 22,4), p: 0,011) CIN grubunda anlamlı derecede yüksekti. Ayrıca ileri koşullu lojistik regresyon analizi yapıldı ve CSFP'li hastalarda U-II (Oran oranı (OR) = 3,983;% 95 güven aralığı (CI): 2,25 ila 7,052; p <0,001) ve Mehran skorunun (OR = 1,228, %95 CI: 1,083-1,393, p = 0,001) bağımsız olarak CIN gelişimininin öngördürücülerinin olduğu saptandı.

Sonuç: Yüksek serum U-II konsantrasyonları ve yüksek Mehran skorları CSFP hastalarında bağımsız olarak CIN gelişimi ile ilişkili bulunmuştur. Bir yıllık klinik takipte, tüm nedenlere bağlı ölüm, kardiyovasküler ölüm ve MACE bulguları CIN grubunda anlamlı derecede yüksek saptandı, ancak inme ve miyokard infarktüsü oranları her iki grupta da benzer bulundu.

Keywords

• Ürotensin II,Yavaş Akım Fenomeni,Kontrast Kaynaklı Nefropati,perkütan koroner girişim,Major Advers kardiyovasküler olaylar

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