Relationship between monocyte to high-density lipoprotein ratio and contrast-induced nephropathy in patients with non-st elevation myocardial infarction

Öz

Aim: Contrast-induced nephropathy (CIN) is associated with worse prognosis in patients with non-ST-elevation myocardial infarction (NSTEMI). Early identification patients with a high risk of CIN are very crucial to improve outcomes. The monocyte to high-density lipoprotein ratio (MHR) is a novel inflammatory marker. We aimed to investigate the MHR had a predictive role for CIN development in patients with NSTEMI.
Material and Methods: NSTEMI who underwent percutaneous coronary intervention (PCI) were included in the study. MHR was calculated and CIN was defined as an increase in serum creatinine 25% or 0.5 mg/dl from baseline in the first 48- 72 hours.

Results: A total of 370(200, 54.1% men) patients were included in this study and 104 (28.1%) of them had DM. 25 (6.7%) of patients had CIN. MHR was significantly higher in patients with CIN (0.014± 0.004 vs 0.011± 0.006-respectively, p: 0.017). MHR was also significantly correlated with creatinine levels after PCI (r:0,104, p: 0.047). CIN group also experienced a more complicated in-hospital clinical course. Additionally; weight and MHR were detected as independent risk factors of CIN in logistic regression analysis.
Conclusion: Preprocedural MHR may be used as cheap, easy and simple marker of CIN. It may help with the early identification of patients with NSTEMI who are at high risk of CIN.

Anahtar Kelimeler

• myocardial infarction,contrast-induced nephropathy,monocyte to high-density lipoprotein ratio

Monosit/yüksek-dansiteli lipoprotein oranının st elevasyonu olmayan miyokard enfarktüslü hastalarda kontrasta bağlı nefropatiyle ilişkisi

Öz

Amaç: Kontrast madde kullanımına bağlı nefropati (KBN) gelişimi perkutan koroner girişim (PKG) yapılan ST elevasyonu olmayan miyokard enfarktüsü (NON-STEMI) geçiren hastalarda sık görülmekte olup artmış mortalite ve morbidite ile ilişklidir. KBN açısından yüksek riskli hastaların önceden tespiti ve tedavisi, klinik sonuçların iyileşmesinde etkili olacaktır. Monosit yüksek dansiteli lipoprotein (HDL) oranı ( MHO) klinikte yeni tanımlanan inflamasyon belirteçlerinden biridir. Çalışamızda işlem öncesi MHO’ nın PKG yapılmış NON-STMI hastalarında KBN gelişimi arasıdaki ilişki araştırılmıştır.
Gereç ve Yöntemler: Çalışmamızda retrospektif olarak NON-STEMI tanısıyla PKG yapılan hastalar incelenmiştir. Hastaneye başvuruşunda alınan örneklerden MHO oranın hesaplanmış ve KBN; işlemden 48-72 saat sonra bakılan serum kreatininde bazal değere göre % 25 ya da 0,5 mg/dl artış olarak tanımlanmıştır.
Bulgular: Toplam 370 (200, %54.1 erkek ) hasta geriye dönük incelenmiş, 25 (%6.7) hastada KBN geliştiği saptanmıştır. Ayrıca hastaların 104’ünde (%28.1) Diabetes Mellitus (DM) olduğu görülmiştür. MHO; KBN gelilşen grupta gelişmeyen gruba göre anlamlı olarak yüksek saptandı (sırasıyla 0.014± 0.004 ve 0.011± 0.006, p: 0.017). Ek olarak MHO ile PKG sonrası kreatinin değerleri arasında pozitif korelasyon saptandı (r:0,104, p: 0.047). Beklendiği gibi KBN gelişen hastların yatışları sırasında daha çok komplikasyon olduğu görüldü. Ayrıca; kilo ve MHO değerleri KBN gelişimi için bağımsız risk faktörleri olarak bulundu.
Sonuç: MHO ucuz, basit ve kolay şekilde saptanabilen inflamasyon belirteci olup, PKG yapılan NON-STEMI hastlarında KBN’nin saptanmasında ve tedavinin yönlendirilmesinde faydalı olabilir.

Anahtar Kelimeler

• Miyokard enfarktüsü,Kontrast madde kullanımına bağlı nefropati,monosit yüksek dansiteli lipoprotein oranı

Kaynakça

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