Akut koroner sendromda kontrast nefropati gelişimi ile Syntax Skoru arasındaki ilişki

Ali Bağcı; Fatih Aksoy; Hasan Aydın Baş

doi:10.17826/cumj.512112

TR EN

Akut koroner sendromda kontrast nefropati gelişimi ile Syntax Skoru arasındaki ilişki

Öz

Amaç: Bu çalışmada akut koroner sendrom tanılı hasta grubunda Syntax (SYNergy between PCI with TAXUS and Cardiac Surgery) (SS) skorlama sistemi ile kontrast nefropatisi (KN) gelişimi arasındaki ilişkiyi tespit etmeyi amaçladık.

Gereç ve yöntem: Çalışmaya Şubat 2016 ile Eylül 2017 tarihleri arasında akut koroner sendrom (AKS) tanısı konmuş koroner yoğun bakım ünitesinde takip edilen hastalar retrospektif olarak alındı. Koroner angiografi (KAG) yapılmayan veya kabul etmeyen hastalar, daha önceden KABG (koroner arter baypas greft) olan hastalar, orta-ciddi kalp kapak hastalığı olan hastalar ve diyalize giren hastalar çalışmaya alınmadı. Bu şartları sağlayan toplam 360 hasta çalışmaya alındı. Hastalar kontrast nefropati gelişen ve gelişmeyen olmak üzere iki gruba ayrıldı. Kontrast nefropati gelişiminin bağımsız belirteçleri çoklu regresyon analizine ile belirlendi.

Bulgular: Hastaların 273 (%78)'ı erkek idi. Hastaların 79 ‘unda (%22) KN geliştiği tesbit edildi. Syntax Skoru KN gelişenlerde 16,2±8,5, gelişmeyenlerde 13,5±8,2 olarak tespit edildi. Çoklu regresyon analizi sonucuna göre yaş (Olasılık Oranı=1,04; %95 Güvenlik Aralığı= 1,00-1,08), opak miktarı (Olasılık Oranı= 1,05; %95 Güvenlik Aralığı= 1,03-1,06), Syntax skoru (Olasılık Oranı= 1,86; %95 Güvenlik Aralığı=1,81- 1,91), KN gelişmesi için bağımsız belirteçler olarak bulundu.

Sonuç: Akut koroner sendrom tanısıyla koroner anjiyografi ve perkutan koroner işlem yapılan hastalarda SS ile KN arasında ilişki tespit edildi. Bu çalışmada yaş, SS ve kullanılan opak miktarının KN gelişimi ile bağımsız ilişkili olduğu gösterildi.

Anahtar Kelimeler

akut koroner sendrom,Syntax Skoru,kontrast nefropatisi

Relationship between development of contrast nephropathy and Syntax Score in acute coronary syndrome

Öz

Purpose: The aim of this study was to determine the relationship between Syntax(SYNergy between PCI with TAXUS and Cardiac Surgery) scoring (SS) system and contrast induced nephropathy (CIN) development in patients with acute coronary syndrome.

Materials and Methods: A total of 360 patients who were followed-up in the coronary intensive care unit between February 2016 and September 2017; were included in the study retrospectively. Exclusion criterias were previous coronary artery bypass graft; moderate-severe heart valve disease. Patients on dialysis and who had no coronary angiographic information were also not included. Patients were divided into two groups with and without contrast nephropathy. The independent predictors of contrast nephropathy were determined by multiple regression analysis.

Results: Of the patients, 273 (78%) were male. 79 patients (22%) developed CIN. The SS was found to be 16.2 ± 8.5 in patients with CIN and 13.5 ± 8.2 in those without CIN. According to the results of multiple regression analysis; age (Odds Ratio = 1.04; 95% confidence interval = 1.00 to 1.08), the amount of contrast agent (Odds Ratio = 1.05; 95% confidence interval = 1.03 to 1, 06), SS (odds ratio = 1.86; 95% confidence interval = 1.81 to 1.91) were independent predictors for the development CIN.

Conclusion: Coronary angiography and percutaneous coronary intervention in patients with acute coronary syndrome were found to be correlated with CIN. In this study; age, SS and the amount of contrast agent were independently correlated with the development of CIN.

Anahtar Kelimeler

Acute coronary syndrome,Syntax Score,contrast induced nephropathy

Kaynakça

1. Mehran R, Nikolsky E. Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney international Supplement. 2006(100):S11-5.
2. Pucelikova T, Dangas G, Mehran R. Contrast-induced nephropathy. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. 2008;71(1):62-72.
3. Marenzi G, Lauri G, Assanelli E, Campodonico J, De Metrio M, Marana I, et al. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. Journal of the American College of Cardiology. 2004;44(9):1780-5.
4. Yuan Y, Qiu H, Hu X, Luo T, Gao X, Zhao X, et al. Predictive value of inflammatory factors on contrast-induced acute kidney injury in patients who underwent an emergency percutaneous coronary intervention. Clinical cardiology. 2017;40(9):719-25.
5. Sianos G, Morel M-A, Kappetein AP, Morice M-C, Colombo A, Dawkins K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention. 2005;1(2):219-27.
6. Magro M, Nauta S, Simsek C, Onuma Y, Garg S, van der Heide E, et al. Value of the SYNTAX Score in Patients Treated by Primary Percutaneous Coronary Intervention for Acute ST Elevation Myocardial Infarction—the MI SYNTAXscore Study. Am Heart Assoc; 2010.
7. Ozturk D, Celik O, Erturk M, Kalkan AK, Uzun F, Akturk IF, et al. Utility of the logistic clinical syntax score in the prediction of contrast-induced nephropathy after primary percutaneous coronary intervention. Canadian Journal of Cardiology. 2016;32(2):240-6.
8. Madhavan MV, Généreux P, Rubin J, Palmerini T, Caixeta A, Xu K, et al. Usefulness of the SYNTAX score to predict acute kidney injury after percutaneous coronary intervention (from the Acute Catheterization and Urgent Intervention Triage Strategy Trial). The American journal of cardiology. 2014;113(8):1331-7.
9. Oduncu V, Erkol A, Karabay CY, Şengül C, Tanalp AC, Fotbolcu H, et al. Relation of the severity of contrast induced nephropathy to SYNTAX score and long term prognosis in patients treated with primary percutaneous coronary intervention. International journal of cardiology. 2013;168(4):3480-5.
10. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al. Third universal definition of myocardial infarction. Global heart. 2012;7(4):275-95.

11. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). European heart journal. 2007;28(12):1462-536.
12. Ryden L, Standl E, Bartnik M, Van den Berghe G, Betteridge J, de Boer MJ, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). European heart journal. 2007;28(1):88-136.
13. Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). European heart journal. 2011;32(14):1769-818.
14. Thomsen HS. Guidelines for contrast media from the European Society of Urogenital Radiology. American Journal of Roentgenology. 2003;181(6):1463-71.
15. Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2005;1(2):219-27.
16. Authors/Task Force m, Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). European heart journal. 2014;35(37):2541-619.
17. Malkin CJ, George V, Ghobrial MS, Krishnan A, Siotia A, Raina T, et al. Residual SYNTAX score after PCI for triple vessel coronary artery disease: quantifying the adverse effect of incomplete revascularisation. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2013;8(11):1286-95.
18. Thomsen H, Morcos S. Contrast media and the kidney: European Society of Urogenital Radiology (ESUR) guidelines. The British journal of radiology. 2003;76(908):513-8.
19. Wi J, Ko Y-G, Kim J-S, Kim B-K, Choi D, Ha J-W, et al. Impact of contrast-induced acute kidney injury with transient or persistent renal dysfunction on long-term outcomes of patients with acute myocardial infarction undergoing percutaneous coronary intervention. Heart. 2011;97(21):1753-7.
20. Parfrey PS, Griffiths SM, Barrett BJ, Paul MD, Genge M, Withers J, et al. Contrast material-induced renal failure in patients with diabetes mellitus, renal insufficiency, or both. New England Journal of Medicine. 1989;320(3):143-9.
21. McCullough PA, Wolyn R, Rocher LL, Levin RN, O’Neill WW. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. The American journal of medicine. 1997;103(5):368-75.
22. Muntner P, Whelton PK, Coresh J, Klag MJ, Perneger TV. Exposure to radiologic contrast media and an increased risk of treated end-stage renal disease. The American journal of the medical sciences. 2003;326(6):353-9.
23. Cronin RE. Contrast-induced nephropathy: pathogenesis and prevention. Pediatric Nephrology. 2010;25(2):191-204.
24. Dangas G, Iakovou I, Nikolsky E, Aymong ED, Mintz GS, Kipshidze NN, et al. Contrast-induced nephropathy after percutaneous coronary interventions in relation to chronic kidney disease and hemodynamic variables. The American journal of cardiology. 2005;95(1):13-9.
25. Ogi M, Iwase N, Kitamura T, Sawanobori T, Fujimaki S, Kuramochi M, et al. Risk factors for contrast nephropathy in diabetic patients undergoing cardioangiography. Nihon Jinzo Gakkai shi. 1993;35(2):161-70.
26. Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. circulation. 2002;105(19):2259-64.
27. Brandes RP, Fleming I, Busse R. Endothelial aging. Cardiovascular research. 2005;66(2):286-94.
28. Davidson C, Stacul F, McCullough PA, Tumlin J, Adam A, Lameire N, et al. Contrast medium use. The American journal of cardiology. 2006;98(6):42-58.
29. Marenzi G, Lauri G, Campodonico J, Marana I, Assanelli E, De Metrio M, et al. Comparison of two hemofiltration protocols for prevention of contrast-induced nephropathy in high-risk patients. The American journal of medicine. 2006;119(2):155-62.
30. Chalmers N, Jackson R. Comparison of iodixanol and iohexol in renal impairment. The British journal of radiology. 1999;72(859):701-3.
31. McCullough PA, Stacul F, Becker CR, Adam A, Lameire N, Tumlin JA, et al. Contrast-Induced Nephropathy (CIN) Consensus Working Panel: executive summary. Reviews in cardiovascular medicine. 2006;7(4):177-97.
32. Nozue T, Michishita I, Iwaki T, Mizuguchi I, Miura M. Contrast medium volume to estimated glomerular filtration rate ratio as a predictor of contrast-induced nephropathy developing after elective percutaneous coronary intervention. Journal of cardiology. 2009;54(2):214-20.
33. Lucreziotti S, Centola M, Salerno-Uriarte D, Ponticelli G, Battezzati PM, Castini D, et al. Female gender and contrast-induced nephropathy in primary percutaneous intervention for ST-segment elevation myocardial infarction. International journal of cardiology. 2014;174(1):37-42.
34. Nough H, Eghbal F, Soltani M, Nejafi F, Falahzadeh H, Fazel H, et al. Incidence and main determinants of contrast-induced nephropathy following coronary angiography or subsequent balloon angioplasty. Cardiorenal medicine. 2013;3(2):128-35.
35. Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. Journal of the American College of Cardiology. 2004;44(7):1393-9.
36. Elbasan Z, Şahin DY, Gür M, Kuloğlu O, Kıvrak A, İçen YK, et al. Contrast-induced nephropathy in patients with ST elevation myocardial infarction treated with primary percutaneous coronary intervention. Angiology. 2014;65(1):37-42.

Ayrıntılar

Birincil Dil

Türkçe

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Ali Bağcı ^*
0000-0002-8792-6329
Türkiye

Fatih Aksoy
0000-0002-6480-4935
Türkiye

Hasan Aydın Baş
0000-0001-7110-3443
Türkiye

Yayımlanma Tarihi

29 Aralık 2019

Gönderilme Tarihi

12 Ocak 2019

Kabul Tarihi

6 Mart 2019

Yayımlandığı Sayı

Yıl 2019 Cilt: 44 Sayı: 4

DOI

https://doi.org/10.17826/cumj.512112

IZ

https://izlik.org/JA73TB99AX

APA

Bağcı, A., Aksoy, F., & Baş, H. A. (2019). Akut koroner sendromda kontrast nefropati gelişimi ile Syntax Skoru arasındaki ilişki. Cukurova Medical Journal, 44(4), 1181-1188. https://doi.org/10.17826/cumj.512112

AMA

1.Bağcı A, Aksoy F, Baş HA. Akut koroner sendromda kontrast nefropati gelişimi ile Syntax Skoru arasındaki ilişki. Cukurova Med J. 2019;44(4):1181-1188. doi:10.17826/cumj.512112

Chicago

Bağcı, Ali, Fatih Aksoy, ve Hasan Aydın Baş. 2019. “Akut koroner sendromda kontrast nefropati gelişimi ile Syntax Skoru arasındaki ilişki”. Cukurova Medical Journal 44 (4): 1181-88. https://doi.org/10.17826/cumj.512112.

EndNote

Bağcı A, Aksoy F, Baş HA (01 Aralık 2019) Akut koroner sendromda kontrast nefropati gelişimi ile Syntax Skoru arasındaki ilişki. Cukurova Medical Journal 44 4 1181–1188.

IEEE

[1]A. Bağcı, F. Aksoy, ve H. A. Baş, “Akut koroner sendromda kontrast nefropati gelişimi ile Syntax Skoru arasındaki ilişki”, Cukurova Med J, c. 44, sy 4, ss. 1181–1188, Ara. 2019, doi: 10.17826/cumj.512112.

ISNAD

Bağcı, Ali - Aksoy, Fatih - Baş, Hasan Aydın. “Akut koroner sendromda kontrast nefropati gelişimi ile Syntax Skoru arasındaki ilişki”. Cukurova Medical Journal 44/4 (01 Aralık 2019): 1181-1188. https://doi.org/10.17826/cumj.512112.

JAMA

1.Bağcı A, Aksoy F, Baş HA. Akut koroner sendromda kontrast nefropati gelişimi ile Syntax Skoru arasındaki ilişki. Cukurova Med J. 2019;44:1181–1188.

MLA

Bağcı, Ali, vd. “Akut koroner sendromda kontrast nefropati gelişimi ile Syntax Skoru arasındaki ilişki”. Cukurova Medical Journal, c. 44, sy 4, Aralık 2019, ss. 1181-8, doi:10.17826/cumj.512112.

Vancouver

1.Ali Bağcı, Fatih Aksoy, Hasan Aydın Baş. Akut koroner sendromda kontrast nefropati gelişimi ile Syntax Skoru arasındaki ilişki. Cukurova Med J. 01 Aralık 2019;44(4):1181-8. doi:10.17826/cumj.512112