Abstract | OBJECTIVES: METHODS: We enrolled 251 consecutive patients with STEMI undergoing primary PCI. Receiver operating characteristic curves were used to identify the optimal sensitivity for the observed range of GRACE risk scores. CI-AKI was defined as any of the following: absolute increase in serum creatinine (SCr) of ≥ 0.3 or ≥ 0.5 mg/dL within 48-72 h after contrast exposure, or a percentage increase in SCr level of ≥ 50 %. RESULTS: Forty-three patients (17.1 %) developed CI-AKI0.3, 22 (8.8 %) CI-AKI0.5, and 19 (7.6 %) CI-AKI50. The GRACE quartiles were as follows: Q1 (<136), Q2 (136-159), Q3 (159-180), and Q4 (>180). Patients with high GRACE risk scores had higher risk for CI-AKI0.3, 0.5, and 50 (6.6, 6.6, 23.4, 31.7 %, respectively, p < 0.001; 1.6, 1.6, 9.4, 22.2 %, respectively, p < 0.001; and 3.3, 3.2, 9.4, 14.3 %, respectively, p = 0.009). ROC showed that a GRACE risk score >160 was a fair discriminator for CI-AKI0.3, 0.5, and 50 (C statistic = 0.723, 0.788, 0.668, respectively). After adjusting for potential confounding predictors, GRACE risk score >160 remained significantly associated with CI-AKI0.3 or 0.5 (OR 3.84; 95 % CI 1.61-9.17; p = 0.002, or OR 5.54; 95 % CI 1.42-21.66; p = 0.014), and high-sensitivity C-reactive protein ( Hs-CRP) >15.5 mg/L was a highly significant predictor of CI-AKI0.3, 0.5, and CI-AKI50. CONCLUSIONS: GRACE risk score (>160) and post-procedural Hs-CRP >15.5 mg/L are independent and significant predictors of CI-AKI in patients with STEMI before primary PCI.
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Authors | Yuan Hui Liu, Yong Liu, Ning Tan, Ji-Yan Chen, Jin Chen, Shao-Hui Chen, Yi-Ting He, Peng Ran, Piao Ye, Yun Li |
Journal | International urology and nephrology
(Int Urol Nephrol)
Vol. 46
Issue 2
Pg. 417-26
(Feb 2014)
ISSN: 1573-2584 [Electronic] Netherlands |
PMID | 24265037
(Publication Type: Journal Article, Observational Study)
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Chemical References |
- Contrast Media
- C-Reactive Protein
- Creatinine
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Topics |
- Acute Kidney Injury
(blood, chemically induced)
- Aged, 80 and over
- Area Under Curve
- C-Reactive Protein
(metabolism)
- Contrast Media
(adverse effects)
- Creatinine
(blood)
- Electrocardiography
- Female
- Hospital Mortality
- Humans
- Intra-Aortic Balloon Pumping
- Male
- Middle Aged
- Myocardial Infarction
(physiopathology, surgery)
- Percutaneous Coronary Intervention
(adverse effects)
- Predictive Value of Tests
- Prospective Studies
- ROC Curve
- Respiration, Artificial
- Risk Assessment
(methods)
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