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ZJUS-B
Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology)  2013, Vol. 14 Issue (8): 713-720    DOI: 10.1631/jzus.BQICC706
Articles     
A correlation between acute kidney injury and myonecrosis after scheduled percutaneous coronary intervention
Min Zhang, Hao-yu Meng, Ying-ming Zhao, Zhi-wen Tao, Xiao-xuan Gong, Ze-mu Wang, Bo Chen, Zheng-xian Tao, Chun-jian Li, Tie-bing Zhu, Lian-sheng Wang, Zhi-jian Yang
Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Abstract  Slight elevations in cardiac troponin I and T are frequently observed after percutaneous coronary intervention (PCI). Contrast-induced acute kidney injury (CI-AKI) is a complex syndrome induced by exposure to intravascular contrast media (CM). Currently, the relationships between the CM, pre-existing kidney insufficiency, CI-AKI, and myonecrosis after elective PCI are unclear. To investigate the relationship between CI-AKI and post-procedural myonecrosis (PMN) after PCI, we analyzed 327 non-ST-segment elevation acute coronary syndrome subjects undertaking elective PCI. The levels of cardiac troponins (cTns), cTnI and cTnT, at baseline and on at least one occasion 18–24 h after PCI were measured. We also recorded serum levels of creatinine (SCr) and the urine albumin:creatinine ratio (ACR) before coronary angiography, and 24–48 h and 48–72 h after contrast administration. A post-procedure increase in cTns was detected in 16.21% (53/327) of subjects with cTns levels >99th to 5&time;99th percentile upper reference limit (URL). Twenty-seven patients (8.26%) developed CI-AKI. CI-AKI occurred more often in subjects with PMN than in those without PMN (20.8% versus 5.8%, respectively, P=0.001). Multiple logistic regression analysis revealed that pre-existing microalbuminuria (MA) was an important independent predictor of PMN (OR: 3.31; 95% CI: 1.26–8.65, P=0.01). However, there was no correlation between the incidence of CI-AKI and PMN (OR: 2.38; 95% CI: 0.88–6.46, P=0.09). We conclude that pre-existing MA was not only an important independent predictor of CI-AKI but also of PMN.

Key words： Percutaneous coronary intervention      Myonecrosis      Contrast-induced nephropathy      Acute kidney injury      Contrast media     
Received: 01 July 2013      Published: 30 July 2013
CLC:  R541.4  
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Min Zhang
Chun-jian Li
Tie-bing Zhu
Lian-sheng Wang
Zhi-jian Yang
Hao-yu Meng
Ying-ming Zhao
Zhi-wen Tao
Xiao-xuan Gong
Ze-mu Wang
Bo Chen
Zheng-xian Tao
Cite this article:

Min Zhang, Hao-yu Meng, Ying-ming Zhao, Zhi-wen Tao, Xiao-xuan Gong, Ze-mu Wang, Bo Chen, Zheng-xian Tao, Chun-jian Li, Tie-bing Zhu, Lian-sheng Wang, Zhi-jian Yang. A correlation between acute kidney injury and myonecrosis after scheduled percutaneous coronary intervention. Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology), 2013, 14(8): 713-720.

URL:

http://www.zjujournals.com/xueshu/zjus-b/10.1631/jzus.BQICC706     OR     http://www.zjujournals.com/xueshu/zjus-b/Y2013/V14/I8/713

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