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Acil Serviste Akut Miyokard Enfarktüsü Tanısı Alıp Perkütan Koroner Girişim Uygulanan ve Kontrast Nefropati Gelişen Hastaların Analizi

Year 2021, Volume: 4 Issue: 2, 39 - 42, 29.06.2021

Abstract

Amaç: Çalışmamızda, acil serviste akut miyokardiyal enfarktüs (AMI) tanısı alan ve perkutan koroner anjiyografi (PKA) uygulanan hastalarda, kontrast kaynaklı akut böbrek hasarının (CI-AKI) insidansını ve klinik prediktörlerini belirlemek amaçlandı.

Gereç ve Yöntemler: Çalışmamıza 422 hasta dâhil edildi. Hastaların, kan troponin, alanin aminotransferaz (ALT), aspartat aminotransferaz (AST) düzeyleri, başvuru sırasındaki ve PKA’dan üç gün sonraki serum kreatinin (Cr) düzeyleri, N-terminal pro-beyin natriüretik peptid (NT-proBNP) seviyeleri, elektrokardiyogram (EKG) bulguları, sol ventriküler ejeksiyon fraksiyonu (LVEF) ve anjiyografi sonuçlarını kaydettik. İncelenen parametreler ile CI-AKI oluşumları arasındaki ilişkiyi analiz ettik.

Bulgular: CI-AKI hastaların% 9.7'sinde görüldü. CI-AKI ile yaş, cinsiyet, AST, ALT, başvuru anındaki kreatinin düzeyleri, kardiyak disfonksiyon varlığı arasında istatistiksel olarak anlamlı bir ilişki vardı (P <0.001, P <0.01, P <0.01, P <0.05, P <0.001, P < 0.05).

Sonuç: Çalışmamıza göre; Yaş> 70, anormal pre-PCA kreatinin, kadın cinsiyet, yüksek bazal AST-ALT seviyeleri, kardiyak disfonksiyon, AMI tedavisi için PKA uygulanan hastalarda CI-AKI gelişimini öngörebilir.

Supporting Institution

YOK

Thanks

YOK

References

  • Barrett BJ, Parfrey PS. Clinical practice. Preventing nephropathy induced by contrast medium. N Engl J Med. 2006; 26;354(4):379-86.
  • Guitterez NV, Diaz A, Timmis GC, et al. Determinants of serum creatinine trajectory in acute contrast nephropathy. J Interv Cardiol. 2002; 15(5):349-54.
  • Kumar S, Nair RK, Aggarwal N, et al. Risk factors for contrast-induced nephropathy after coronary angiography.Saudi J Kidney Dis Transpl. 2017;28(2):318-24.
  • Zijlstra F, Hoorntje JC, de Boer MJ, et al. Long-term benefit of primary angioplasty as compared with thrombolytic therapy for acutemyocardial infarction. N Engl J Med. 1999;341:1413-19.
  • Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet. 2003;361:13–20.
  • Chalikias G, Drosos I, Tziakas DN. Contrast-Induced Acute Kidney Injury: An Update.Cardiovasc Drugs Ther. 2016;30(2): 215-28.
  • Gruberg L, Mehran R, Dangas G, et al. Acute renal failure requiring dialysis after percutaneous coronary interventions. Catheter Cardiovasc Interv. 2001;52(4):409-16.
  • Rihal CS, Textor SC, Grill DE, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation. 2002(14);105(19):2259-64.
  • Marenzi G, Lauri G, Assanelli E, et al. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol. 2004;44:1780–85.
  • Chong E, Poh KK, Liang S, et al. Comparion of risks and clinical predictors of contrast-induced nephropathy in patients undergoing emergency versus nonemergency percutaneous coronary interventions. J Interv Cardiol. 2010;23(5):451-9.
  • Yuan Y, Qiu H, Hu XY, et al. Risk Factors of Contrast-induced Acute Kidney Injury in Patients Undergoing Emergency Percutaneous Coronary Intervention. Chin Med J (Engl). 2017;130(1):45-50.
  • Mehran R, Aymong ED, Nikolsky E, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004(6);44(7):1393-9.
  • Sun G, Chen P, Wang K, et al. Contrast-Induced Nephropathy and Long- Term Mortality After Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction. Angiology. 2019 Aug;70(7):621-626. doi: 10.1177/0003319718803677.
  • Liu YH, Jiang L, Chen J, et al. Does N‑terminal pro‑brain natriuretic peptide add prognostic value to the Mehran risk score for contrast‑induced nephropathy and long‑term outcomes after primary percutaneous coronary intervention? Int Urol Nephrol.2016;48(10):1675-82.
  • Lucreziotti S, Centola M, Salerno-Uriarte D, et al. Female gender and contrast-induced nephropathy in primary percutaneous intervention for STsegment elevation myocardial infarction. Int J Cardiol. 2014;1;174(1):37-42.
  • Iakovou I, Dangas G, Mehran R, et al. Impact of gender on the incidence and outcome of contrast induced nephropathy after percutaneous coronary intervention. J Invasive Cardiol. 2003;15(1):18-22.
  • Kurtul A, Duran M, Yarlioglues M, et al. Association Between N-Terminal Pro-Brain Natriuretic Peptide Levels and Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome. Clin Cardiol. 2014;37(8):485-92.

Analysis of Contrast-Induced Nephropathy in Patient with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention in the Emergency Department

Year 2021, Volume: 4 Issue: 2, 39 - 42, 29.06.2021

Abstract

Aim: The purpose of this study was to determine the incidence and predictors of Contrast-induced acute kidney injury (CI-AKI) in emergency patients undergoing primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI).

Material and Methods: We enrolled electrocardiogram (ECG) findings, serum creatinine (Cr), troponin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) levels at pre-PCI and Cr levels post-PCI following three days. Patients’ N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, left ventricular ejection fraction (LVEF) and results of angiography was recorded in 422 patients. We analyzed the relationship between examined parameters and the occurrences of CI-AKI.

Results: CI-AKI occurred in 9.7% of patients. There was a statistically significant relationship between occurrences CI-AKI and age, gender, AST, ALT, creatinine levels at admission, cardiac dysfunction (P<0.001, P<0.01, P<0.01, P<0.05, P<0.001, P<0.05).

Conclusion: According to our study; age>70 years, abnormal pre-PCI creatinine, female gender, high basal AST-ALT levels, cardiac dysfunction may predict CI-AKI development in patients who undergoing PCI for treatment of AMI.

References

  • Barrett BJ, Parfrey PS. Clinical practice. Preventing nephropathy induced by contrast medium. N Engl J Med. 2006; 26;354(4):379-86.
  • Guitterez NV, Diaz A, Timmis GC, et al. Determinants of serum creatinine trajectory in acute contrast nephropathy. J Interv Cardiol. 2002; 15(5):349-54.
  • Kumar S, Nair RK, Aggarwal N, et al. Risk factors for contrast-induced nephropathy after coronary angiography.Saudi J Kidney Dis Transpl. 2017;28(2):318-24.
  • Zijlstra F, Hoorntje JC, de Boer MJ, et al. Long-term benefit of primary angioplasty as compared with thrombolytic therapy for acutemyocardial infarction. N Engl J Med. 1999;341:1413-19.
  • Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet. 2003;361:13–20.
  • Chalikias G, Drosos I, Tziakas DN. Contrast-Induced Acute Kidney Injury: An Update.Cardiovasc Drugs Ther. 2016;30(2): 215-28.
  • Gruberg L, Mehran R, Dangas G, et al. Acute renal failure requiring dialysis after percutaneous coronary interventions. Catheter Cardiovasc Interv. 2001;52(4):409-16.
  • Rihal CS, Textor SC, Grill DE, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation. 2002(14);105(19):2259-64.
  • Marenzi G, Lauri G, Assanelli E, et al. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol. 2004;44:1780–85.
  • Chong E, Poh KK, Liang S, et al. Comparion of risks and clinical predictors of contrast-induced nephropathy in patients undergoing emergency versus nonemergency percutaneous coronary interventions. J Interv Cardiol. 2010;23(5):451-9.
  • Yuan Y, Qiu H, Hu XY, et al. Risk Factors of Contrast-induced Acute Kidney Injury in Patients Undergoing Emergency Percutaneous Coronary Intervention. Chin Med J (Engl). 2017;130(1):45-50.
  • Mehran R, Aymong ED, Nikolsky E, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004(6);44(7):1393-9.
  • Sun G, Chen P, Wang K, et al. Contrast-Induced Nephropathy and Long- Term Mortality After Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction. Angiology. 2019 Aug;70(7):621-626. doi: 10.1177/0003319718803677.
  • Liu YH, Jiang L, Chen J, et al. Does N‑terminal pro‑brain natriuretic peptide add prognostic value to the Mehran risk score for contrast‑induced nephropathy and long‑term outcomes after primary percutaneous coronary intervention? Int Urol Nephrol.2016;48(10):1675-82.
  • Lucreziotti S, Centola M, Salerno-Uriarte D, et al. Female gender and contrast-induced nephropathy in primary percutaneous intervention for STsegment elevation myocardial infarction. Int J Cardiol. 2014;1;174(1):37-42.
  • Iakovou I, Dangas G, Mehran R, et al. Impact of gender on the incidence and outcome of contrast induced nephropathy after percutaneous coronary intervention. J Invasive Cardiol. 2003;15(1):18-22.
  • Kurtul A, Duran M, Yarlioglues M, et al. Association Between N-Terminal Pro-Brain Natriuretic Peptide Levels and Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome. Clin Cardiol. 2014;37(8):485-92.
There are 17 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Yeliz Simsek 0000-0003-2362-2112

Selen Surer This is me 0000-0001-7653-6643

Salim Satar 0000-0001-6080-4287

Yahya Kemal İçen 0000-0003-0070-5281

Publication Date June 29, 2021
Published in Issue Year 2021 Volume: 4 Issue: 2

Cite

AMA Simsek Y, Surer S, Satar S, İçen YK. Analysis of Contrast-Induced Nephropathy in Patient with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention in the Emergency Department. Anatolian J Emerg Med. June 2021;4(2):39-42.