Akut Miyokardiyal İnfarktüs Sonrası Primer Anjiyoplasti Uygulanan Hastalarda Kontrastla İlişkili Nefropatinin Bir Prediktörü: Kontrast Madde Hacminin Glomerüler Filtrasyon Hızına Oranı

Year 2021, Volume: 11 Issue: 1, 183 - 192, 22.03.2021

Sedat Taş , Eren Ozan Bakır , Ümmü Taş

https://doi.org/10.31832/smj.786134

Abstract

Amaç

Akut miyokard infarktüsü nedeni ile perkütan koroner girişim yapılan hastalarda, kontrast madde hacminin glomerüler filtrasyon hızına oranının (KV/GFH) kontrast ilişkili nefropatiyi (KİN) öngördürmedeki etkisini belirlemek ve KİN gelişiminden sakınmak amacı ile güvenli bir KV/GFH eşik değeri tanımlamak.
Gereç ve Yöntemler

Akut myokard infarktüsü nedeni ile perkütan koroner girişim yapılan 108 hasta değerlendirildi. Hastalar perkütan koroner girişimden 48 saat sonra bakılan serum kreatinin değerlerindeki değişime göre, KİN gelişen ve KİN gelişmeyen olarak iki gruba ayrıldı. Ardından KİN ile ilişkili olan risk faktörlerinin analizi yapıldı. Receiver operating characteristic (ROC) eğrisi kullanılarak KİN gelişimini belirlemek amacıyla KV/GFH için optimal bir eşik değer belirlendi ve lojistik regresyon kullanılarak KİN’i öngördüren bağımsız değişkenler tanımlandı.
Bulgular
Hastalar içinde KİN gelişim oranı %24 olarak saptandı. KV/GFH anlamlı olarak KIN gelişen grupta daha yüksek bulundu. ROC eğrisi analizi ile elde edilen KV/GFH>2.68 değeri, KİN gelişimini öngörmede %92 sensitivite ve %89 spesifisiteye sahipti. KV/GFH dışında, yaş ve HDL-K da KİN için bağımsız risk faktörleri olarak saptandı.
Sonuç
Akut myokard infarktüsü nedeni ile perkütan koroner girişim yapılan hastalarda, KV/GFH>2.68 değeri KİN’i öngördürmede anlamlı bağımsız bir değişkendir. Bu değer PKG yapılacak hastalarda kontrast madde kullanımını yönetmek açısından kullanışlı olabilir.

Keywords

Kontrast ilişkili nefropati, kontrast madde hacmi, akut miyokardiyal infarktüs, perkütan koroner girişim, yüksek dansiteli lipoprotein

References

• 1. Toprak O. Risk markers for contrast-induced nephropathy. Am J Med Sci 2007; 334: 283-90
• 2. Romano G, Briguori C, Quintavalle C, Zanca C, Rivera NV, Colombo A, et al. Contrast agents and renal cell apoptosis. Eur Heart J. 2008; 29: 2569–76
• 3. Pucelikova T, Dangas G, Mehran R. Contrast-induced nephropathy. Catheter Cardiovasc Interv. 2008; 71: 62–72
• 4. Marenzi G, Assanelli E, Campodonico J, Lauri G, Marana I, De Metrio M et al. Contrast volume during primary percutaneous coronary intervention and subsequent contrast-induced nephropathy and mortality. - Ann Intern Med. 2009; 150: 170-7.
• 5. Perrin T, Descombes E, Cook S. Contrast-induced nephropathy in invasive cardiology. Swiss Med Wkly. 2012; 142: w13608
• 6. Bolognese L, Falsini G, Schwenke C, Grotti S, Limbruno U, Liistro F et al. Impact of iso-osmolar versus low-osmolar contrast agents on contrast-induced nephropathy and tissue reperfusion in unselected patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (from the Contrast Media and Nephrotoxicity Following Primary Angioplasty for Acute Myocardial Infarction [CONTRAST-AMI] Trial). Am J Cardiol 2012; 109: 67-74.
• 7. Solomon RJ, Mehran R, Natarajan MK, Doucet S, Katholi RE, Staniloae CS et al. Contrast-Induced Nephropathy and Long-Term Adverse Events: Cause and Effect? CJASN. 2009; 4: 1162-1169.
• 8. Celik O, Ozturk D, Akin F, Ayca B, Yalçın AA, Ertürk M et al. Association Between Contrast Media Volume-Glomerular Filtration Rate Ratio and Contrast-Induced Acute Kidney Injury After Primary Percutaneous Coronary Intervention. Angiology. 2015; 66: 519-524
• 9. Cochran ST, Bomyea K, Sayre JW. Trends in adverse events after IV administration of contrast media. AJR Am J Roentgenol 2001; 176: 1385–1388
• 10. Katayama H, Yamaguchi K, Kozuka T, Takashima T, Seez P, Matsuura K. Adverse reactions to ionic and nonionic contrast media: a report from the Japanese Committee on the Safety of Contrast Media. Radiology 1990; 175: 621–628
• 11. Nie B, Cheng WJ, Li YF, Cao Z, Yang Q, Zhao YX, et al. A prospective, double-blind, randomized, controlled trial on the efficacy and cardiorenal safety of iodixanol vs. iopromide in patients with chronic kidney disease undergoing coronary angiography with or without percutaneous coronary intervention. Catheter Cardiovasc Interv. 2008; 72: 958–65
• 12. Jo SH, Youn TJ, Koo BK, Park JS, Kang HJ, Cho YS, et al. Renal toxicity evaluation and comparison between visipaque (iodixanol) and hexabrix (ioxaglate) in patients with renal insufficiency undergoing coronary angiography: The RECOVER study: A randomized controlled trial. J Am Coll Cardiol. 2006; 48: 924–30
• 13. Laskey W, Aspelin P, Davidson C, Rudnick M, Aubry P, Kumar S, et al. DXV405 Study Group. Nephrotoxicity of iodixanol versus iopamidol in patients with chronic kidney disease and diabetes mellitus undergoing coronary angiographic procedures. Am Heart J. 2009; 158: 822–8
• 14. Kuhn MJ, Chen N, Sahani DV, Reimer D, van Beek EJ, Heiken JP, et al. The PREDICT study: A randomized double-blind comparison of contrast-induced nephropathy after low- or isoosmolar contrast agent exposure. AJR Am J Roentgenol. 2008; 191: 151–7
• 15. Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl SR, Cercek B et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions [published correction appears in Circulation. 2012 Feb 28;125(8):e412. Dosage error in article text]. Circulation. 2011; 124: e574-e651
• 16. Nyman U, Bjork J, Aspelin P, Marenzi G. Contrast medium dose-to- GFH ratio: A measure of systemic exposure to predict contrast-induced nephropathy after percutaneous coronary intervention. Acta Radiol. 2008; 49: 658–67
• 17. Manske CL, Sprafka JM, Strony JT, Wang Y. Contrast nephropathy in azotemic diabetic patients undergoing coronary angiography. Am J Med. 1990; 89: 615–20
• 18. Brown JR, Robb JF, Block CA, Schoolwerth AC, Kaplan AV, O’Connor GT, et al. Does safe dosing of iodinated contrast prevent contrast-induced acute kidney injury? Circ Cardiovasc Interv. 2010; 3: 346–50
• 19. Çiçek G, Bozbay M, Açıkgöz SK, Altay S, Uğur M, Köroğlu B et al. The ratio of contrast volume to glomerular filtration rate predicts in-hospital and six-month mortality in patients undergoing primary angioplasty for ST-elevation myocardial infarction. Cardiol J. 2015;22:101-107.
• 20. Yang Y, George KC, Luo R, Cheng Y, Shang W, Ge S et al. Contrast-induced acute kidney injury and adverse clinical outcomes risk in acute coronary syndrome patients undergoing percutaneous coronary intervention: a meta-analysis. BMC Nephrol. 2018; 19: 374
• 21. Reyes LF, Severiche-Bueno DF, Bustamante CA, Murillo S, Soni NJ, Poveda M et al. Serum levels of neutrophil Gelatinase associated Lipocalin (NGAL) predicts hemodialysis after coronary angiography in high risk patients with acute coronary syndrome. BMC Nephrol. 2020; 21: 143
• 22. He Y, Deng Y, Zhuang K, Li S, Xi J, Chen J. Predictive value of cystatin C and neutrophil gelatinase-associated lipocalin in contrast-induced nephropathy: A meta-analysis. PLoS One. 2020; 15: e0230934
• 23. Kuo CS, Chou RH, Lu YW, Tsai YL, Huang PH, Lin SJ. Increased circulating galectin-1 levels are associated with the progression of kidney function decline in patients undergoing coronary angiography. Sci Rep. 2020; 10: 1435
• 24. Ling W, Zhaohui N, Ben H, Leyi G, Jianping L, Huili D et al. Urinary IL-18 and NGAL as early predictive biomarkers in contrast-induced nephropathy after coronary angiography. Nephron Clin Pract. 2008; 108: c176-c181
• 25. Mueller C. Prevention of contrast-induced nephropathy with volume supplementation. Kidney Int Suppl. 2006; 100: S16-S19
• 26. Çiçek G, Bozbay M, Açıkgöz SK, Altay S, Uğur M, Köroğlu B et al. The ratio of contrast volume to glomerular filtration rate predicts in-hospital and six-month mortality in patients undergoing primary angioplasty for ST-elevation myocardial infarction. Cardiol J. 2015; 22: 101-107
• 27. Mager A, Vaknin Assa H, Lev EI, Bental T, Assali A, Kornowski R. The ratio of contrast volume to glomerular filtration rate predicts outcomes after percutaneous coronary intervention for ST-segment elevation acute myocardial infarction. Catheter Cardiovasc Interv. 2011; 78: 198-201
• 28. Zahler D, Rozenfeld KL, Merdler I, Peri Y, Shacham Y. Contrast Volume to Glomerular Filtration Ratio and Acute Kidney Injury among ST-Segment Elevation Myocardial Infarction Patients Treated with Primary Percutaneous Coronary Intervention. Cardiorenal Med. 2020; 10: 108-115
• 29. Marenzi G, Assanelli E, Campodonico J, Lauri G, Marana I, Metrio MD et al. Contrast volume during primary percutaneous coronary intervention and subsequent contrast-induced nephropathy and mortality. Ann Intern Med. 2009; 150: 170-177
• 30. Yuan Y, Qiu H, Hu XY, Luo T, Gao XJ, Zhao XY et al. Relationship between High Level of Estimated Glomerular Filtration Rate and Contrast-Induced Acute Kidney Injury in Patients who Underwent an Emergency Percutaneous Coronary Intervention. Chin Med J (Engl). 2018; 131: 2041-2048
• 31. Fernández-Rodríguez D, Grillo-Pérez JJ, Pérez-Hernández H, Rodriguez-Esteban M, Pimienta R, Acosta-Materan C et al. Prospective evaluation of the development of contrast-induced nephropathy in patients with acute coronary syndrome undergoing rotational coronary angiography vs. conventional coronary angiography: CINERAMA study. Nefrologia. 2018; 38: 169-178
• 32. Gulcu O. The association between neutrophil to lymphocyte ratio and contrast induced nephropathy in patients with ST segment elevation myocardial infarction. Annals of Medical Research. 2019; 26: 1184-8
• 33. Zorlu C, Koseoglu C. Comparison of the Relationship Between Inflammatory Markers and Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome After Coronary Angiography. Angiology. 2020; 71: 249-255.
• 34. Kaya A, Karataş A, Kaya Y, Düğeroğlu H, Dereli S, Bayramoğlu A. A New and Simple Risk Predictor of Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention: TIMI Risk Index. Cardiol Res Pract. 2018; 2018: 5908215
• 35. Cho JY, Jeong MH, Hwan Park S, Kim IS, Park KH, Sim DS et al. Effect of contrast-induced nephropathy on cardiac outcomes after use of nonionic isosmolar contrast media during coronary procedure. J Cardiol. 2010;56:300-306
• 36. Ni Z, Liang Y, Xie N, Liu J, Sun G, Chen S et al. Simple pre-procedure risk stratification tool for contrast-induced nephropathy. J Thorac Dis. 2019;11:1597-1610
• 37. Ulus T, Isgandarov K, Yilmaz AS, Uysal S, Vasi İ, Dural M et al. Monocyte to High-Density Lipoprotein Ratio Predicts Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome. Angiology. 2018; 69: 909-916
• 38. Kirişçi M. A Promising Marker for Carotid Artery Disease: Monocyte to High-density Lipoprotein Cholesterol Ratio. Sakarya Med J. 2020;10:93-98
• 39. Turan B, Erkol A, Gül M, Fındıkçıoğlu U, Erden İ. Effect of Contrast-Induced Nephropathy on the Long-Term Outcome of Patients with Non-ST Segment Elevation Myocardial Infarction. Cardiorenal Med. 2015; 5: 116-124
• 40. Zaid M, Miura K, Okayama A, Nakagava H, Sakata K, Okuda N et al. Associations of High-Density Lipoprotein Particle and High-Density Lipoprotein Cholesterol With Alcohol Intake, Smoking, and Body Mass Index　- The INTERLIPID Study. Circ J. 2018; 82: 2557-2565