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

Year 2019, Volume: 9 Issue: 3, 442 - 454, 16.09.2019

Mustafa Huyut

https://doi.org/10.31832/smj.596933

Cited By: 1

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

Supporting Institution

Bezmialem Vakıf Üniversitesi

Project Number

5.2016/17

Thanks

The author thanks Betul Cetintulum Huyut, PhD. Cand., for her statistical analysis contributions in preparing this manuscript.

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

Project Number

5.2016/17

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