Akut miyokart enfarktüsü nedeniyle perkütan koroner girişim uygulanan hastalarda kontrast-kaynaklı akut böbrek hasarı tespitinde C-reaktif proteinin-albümin oranının öngördürücü değeri

Öz

Amaç: Bu çalışmada akut miyokart enfarktüsü (AME) nedeniyle primerperkütan koroner girişim (pPKG) yapılan hastalarda kontrast-kaynaklı akut böbrek hasarı (KK-ABH) gelişiminde C-reaktif protein - albümin oranının (CAO) öngördürücü değerini belirlenmesi amaçlamaktadır. Materyal ve Metot: Çalışmaya pPKG uygulanan ST-elevasyonsuz ve ST-elevasyonu 210 AME’li hasta dâhil edildi. Hastaların pPKG sonrası böbrek fonksiyon parametreleri ve en yüksek CAO değerleri hasta dosyalarından kaydedildi. Çalışma popülasyonunun CAO değerleri en küçükten en büyüğe doğru sıralandıktan sonra düşük-, orta- ve yüksek-CAO olmak üzere üç guruba ayrıldı (her n = 70). Bulgular: Seksen dokuz hastada (% 42.38) KK-ABH gelişti. Serum kreatininindeki (sCr) mutlak artışı, yüksek-CAO gurubunda [.31, interquartilerange (IQR): 1.925-.555], düşük- (.2, IQR: .118 - .27) ve orta-CAO’dan önemli ölçüde daha yüksek bulundu (.2, IQR: .13 - .33; p < .001). Receiveroperatingcharacteristic analizde CAO’ya ait eğri altındaki alan 0.689 (95% CI: .614-.763; p < .001) bulundu. KK-ABH gelişimine neden olacak diğer risk faktörleri ayarlandıktan sonra yapılan çok değişkenli regresyon analizi, CAO’nun KK-ABH gelişimini öngördürecek olduğunu gösterdi (OR: 1.345,% 95 CI: 1.009-1.794, p = .043). Sonuçlar: Yüksek CAO değerleri, pPCI uygulanan AME hastalarında KK-ABH gelişiminde bağımsız öngördürücüdür. Bu hasta grubunda, pPKG sonrası yüksek CAO değeri KK-ABH'nın gelişebileceği yönünde bizi uyarmalıdır.

Anahtar Kelimeler

• Akut miyokart enfarktüsü
• C-reaktif proteinin albümin oranı
• kontrast- kaynaklı akut böbrek hasarı

The predictive value of C-reactive protein to albumin ratio to detect contrast-induced acute kidney injury in patients with acute myocardial infarction undergoing percutaneous coronary intervention

Öz

Aim: The present study aims to investigate the predictive value of the peak C-reactive protein to reduced albumin ratio (CAR) in the development of contrast-induced acute kidney injury (CI-AKI) in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (pPCI). Material and Method: Two hundred and ten patients with non-ST and ST-elevation AMI undergoing pPCI were recorded. Renal function parameters and highest CAO values of the patients after pPCI were recorded from the patient files. The patient population was divided intothe low-, mid-, and high-CAR tertiles (all n = 70) after their CAR values were ranked from least to greatest. Results: Eighty-nine (42.38%) patients developed CI-AKI. The absolute increase in serum creatinine (sCr) was significantly higher in patients in the high-CAR tertile (.31, interquartile range (IQR): 1.925-.555) than in the low-CAR (.2, IQR: .118-.27) and mid-CAR tertiles (.2, IQR: .13-.33; p <.001). The area under the curve of CAR was .689 (95% CI: .614-.763; p < .001) in the receiver operating characteristic analysis. After adjusting for other risk factors of CI-AKI, CAR remained predictors of the development of CI-AKI (OR: 1.345, 95% CI: 1.009-1.794, p = .043). Conclusions: The elevated CAR value is independent predictors in the development of CI-AKI in patients with AMI undergoing pPCI.In this patient group, the elevated CAR value after pPKG may alert us to more improve CI-AKI.

Anahtar Kelimeler

• Acute myocardial infarction
• C-reactive protein to albumin ratio
• contrast-induced acute kidney injury

Kaynakça

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