SYNTAX score of infarct-related artery other than the number of coronary balloon inflations and deflations as an independent predictor of contrast-induced acute kidney injury in patients with ST-segment elevation myocardial infarction

Cheng Wei Liu, Pen Chih Liao, Kuo Chin Chen, Jung Cheng Hsu, Chung Ming Tu, Yen Wen Wu, Ai Hsien Li, Shin Rong Ke, Jiunn Lee Lin

研究成果: 雜誌貢獻文章同行評審

5 引文 斯高帕斯(Scopus)

摘要

Background: Although remote ischemic post-conditioning (RIPC) has been shown to prevent contrast-induced acute kidney injury (CIAKI) in patients with acute coronary syndrome, its efficacy in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. We examined the relationship among balloon inflations and deflations (BID) times, SYNTAX score of infarction-related artery (SI), periprocedural complications, and CIAKI in STEMI patients undergoing primary percutaneous coronary intervention (pPCI). Methods: Patients with STEMI undergoing pPCI with Mehran risk score (MRS) ≥ 5 were enrolled between February 2007 and September 2012. The study end point was the development of CIAKI. Results: Of 206 patients, the median age was 65 years [interquartile range (IQR): 55-77] with 72.8% male and Mehran risk score (MRS) 8 (IQR: 6-12). Receiver operating characteristic curve showed that BID times > 9 times or SI > 10was the best cut-off associated with CIAKI. In univariate analysis, significant associationwith CIAKI existed in BID > 9 times [odds ratio (OR): 3.106, 95% confidence interval (CI): 1.284-7.513, p = 0.012] and SI > 10 (OR: 3.909, 95% CI: 1.570-9.735, p = 0.003). Other variables associated with CIAKI included creatinine, hemoglobin, angiotensin converting enzyme inhibitor or angiotensin receptor blocker use at discharge. In multivariate analysis, SI > 10 remained an independent predictor of CIAKI in different adjustment model, even on top of MRS (adjusted OR: 3.498, 95% CI: 1.086-11.268, p = 0.036). Conclusions: Vascular complexity of infarct-related artery rather than higher BID times (> 9) was the major determinant of the development of CIAKI after pPCI in STEMI patients.

原文英語
頁(從 - 到)362-376
頁數15
期刊Acta Cardiologica Sinica
33
發行號4
DOIs
出版狀態已發佈 - 七月 2017
對外發佈

ASJC Scopus subject areas

  • 心臟病學與心血管醫學

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