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Eur Heart J：对比剂诱导急性肾损伤与PCI患者转归不佳相关

2014-03-12 佚名 医学论坛网

PCI心肌梗死肾损伤
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美国一项研究表明，在ST段抬高性心肌梗死(STEMI)患者中，对比剂诱导的急性肾损伤(CI-AKI)与其直接经皮冠状动脉介入治疗(PCI)后短期和长期转归不佳有相关性。相关论文3月6日在线发表于《欧洲心脏杂志》(Eur Heart J)。该研究利用多变量分析判定CI-AKI和主次要终点的预测因子，以暴露于对比剂后48小时内患者血肌酐水平增加≥0.5 mg/dL或25%定义为CI-AKI。结果显示，

美国一项研究表明，在ST段抬高性心肌梗死(STEMI)患者中，对比剂诱导的急性肾损伤(CI-AKI)与其直接经皮冠状动脉介入治疗(PCI)后短期和长期转归不佳有相关性。相关论文3月6日在线发表于《欧洲心脏杂志》(Eur Heart J)。

该研究利用多变量分析判定CI-AKI和主次要终点的预测因子，以暴露于对比剂后48小时内患者血肌酐水平增加≥0.5 mg/dL或25%定义为CI-AKI。

结果显示，列队中STEMI 患者中CI-AKI的发生率为16.1% (479/2968)。CI-AKI的预测因子为对比剂体积、白细胞计数、左前降支梗死相关动脉、年龄、贫血、肌酐清除率<60 mL/min 和充血性心力衰竭病史。合并CI-AKI的患者30天和3年不良临床事件净发生率较高(P均< 0.0001)。这些患者的30天和3年死亡率也较高(P均< 0.0001)。多变量分析显示，CI-AKI是不良临床事件净发生率[(HR)1.53，P= 0.0001]、主要心脏不良事件(HR 1.56，P= 0.0002)、非冠状动脉旁路移植术严重出血(HR 2.07，P< 0.0001)和随访3年死亡(HR 1.80，P= 0.005)的独立预测因子。

原始出处：

Narula A1, Mehran R, Weisz G, Dangas GD, Yu J, Généreux P, Nikolsky E, Brener SJ, Witzenbichler B, Guagliumi G, Clark AE, Fahy M, Xu K, Brodie BR, Stone GW.Contrast-induced acute kidney injury after primary percutaneous coronary intervention: results from the HORIZONS-AMI substudy.Eur Heart J. 2014 Mar 6.


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    2014-04-19 zhmscau

    #PCI患者#

    0

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    2014-03-14 zhaojie88

    #ART#

    0

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    2014-03-14 智者为医08

    #损伤#

    0

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    2014-03-14 爆笑小医

    #HEART#

    0

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    2014-03-12 lovetcm

    国内介入中，水化往往不充分，加大对比剂肾病的风险

    0

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