Platelet-to-lymphocyte ratio predicts contrast-induced nephropathy in acute myocardial infarction

Yıl 2017, Cilt: 8 Sayı: 3, 97 - 104, 01.06.2017

Regayip Zehir Taner Sarak Sinan Zehir

https://doi.org/10.18663/tjcl.277964

Öz

Aim: Contrast-induced nephropathy
(CIN) is responsible for an increased mortality rate and correlates with
increases in hospital stays and the risk of cardiovascular complications. The
platelet to lymphocyte ratio (PLR) was introduced as a potential marker to determine
the balance between thrombosis and inflammation and was associated with
increased cardiovascular morbidity and mortality. We investigated whether PLR
on admission is an independent risk factor that predicts the development of CIN
in patients with ST-segment elevation myocardial infarction (STEMI) underwent
primary percutaneous coronary intervention (pPCI).

Material
and Methods: 1348 consecutive patients with acute STMI who were
admitted to our institution and underwent pPCI were retrospectively evaluated.
Data obtained from hospital files and computer records. CIN development was
accepted as the endpoint.

Results: A total of 127 (9.4%)
patients experienced CIN. 16 patients underwent renal replacement theraphy.
In-hospital mortality rate was found 2.7% (n = 37). Patients were divided into
two groups based on development of CIN. Age (P = 0.001), baseline GFR (P < 0.001),
grade 3 and more chronic kidney disease (P < 0.001), baseline creatinin (P <
0.001), EF (P < 0.001), presence of DM (P < 0.001) were different between
groups. In multivariate analyses, PLR (odds ratio [OR] 1.012, 95% confidence
interval [CI] 1.006-1.017, P < 0.001) was independently predicted CIN
development.

Conclusion: PLR is
easily available, widely used, and relatively cheap biomarker, and is an
independent predictor of CIN development in patients with STEMI undergoing
pPCI.

Anahtar Kelimeler

Platelet/lymphocyte ratio, ST-segment elevation acute myocardial infarction, contrast-induced nephropathy

Akut miyokard infarktüsünde trombosit/lenfosit oranı kontrast nefropatisini öngörür

Öz

Amaç:
Kontrast madde nefropatisi (CIN) uzamış hastanede yatış süresi, artmıs
kardiyovasküler komplikasyonlar ve mortalite ile ilişkilidir.
Trombosit/lenfosit oranı (PLR) tromboz ve inflamasyon arasındaki dengeyi
gösteren potansiyel bir belirteç olarak tanımlanmış ve artan kardiyovasküler
morbidite ve mortalite ile ilişkili bulunmuştur. Biz bu çalışmada PLR’nin
primer perkütan koroner girişim (pPCI) yapılan ST yükselmeli miyokard infarktüsü
(STEMI) hastalarda CIN gelişimini tahmin etmede bağımsız bir risk faktörü olup
olmadığı araştırdık.

Gereç
ve Yöntemler: Kurumumuza akut STEMI ile başvuran ve pPCI yapılan
1348 hasta geriye dönük olarak değerlendirildi. Hastane dosya ve bilgisayar kayıtlarından
veriler elde edildi. CIN gelişimi sonlanım noktası olarak kabul edildi.

Bulgular: 127 (%9.4) hastada CIN
gelişmişti. 16 hastaya renal replasman tedavisi uygulandı. Hastane içi
mortalite oranı %2,7(n = 37) bulunmuştur. Hastalar CIN gelişimine göre iki
gruba ayrıldı. Yaş (P = 0,001), bazal GFR (P < 0,001), grade 3 ve üzeri
kronik böbrek hastalığı (P < 0,001), bazal kreatinin (P < 0,001), EF (P <
0,001), DM varlığı (P < 0,001) gruplar arasında farklı idi. Çok değişkenli
analizlerde, PLR (odds ratio [OR] 1.012, %95 güven aralığı [CI] 1,006-1,017, P
< 0,001) CIN gelişimini bağımsız olarak öngördü.

Sonuçlar: PLR, kolay ulaşılabilir
yaygın olarak kullanılan ve nispeten ucuz biyomarkerdir ve STEMI nedeniyle pPCI
uygulanan hastalarda CIN gelişiminin bağımsız bir belirleyicisidir.

Anahtar Kelimeler

Trombosit/lenfosit oranı, ST yükselmeli miyokard infarktüsü, kontrast madde nefropatisi

Kaynakça

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