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Primer Perkütan Koroner Girişim Uygulanan St-segment Yükselmesi Miyokart İnfarktüsü Hastalarında Kontrast Nefropatisi Gelişimi İçin Monosit/Yüksek Yoğunluklu Lipoprotein Oranının Öngörülü Değeri

Year 2017, Volume: 20 Issue: 1, 13 - 18, 03.04.2017

Abstract

Giriş: Kontrast madde nefropatisi (KMN) primer perkütan koroner girişim (p-PKG)
uygulanan ST yükselmeli miyokart infarktüsü (STEMİ) hastalarda ciddi bir
komplikasyondur. Monosit/yüksek dansiteli lipoprotein (HDL) oranı (MHR) son
zamanlarda inflamasyon ve oksidatif stres işaretleyici tanımlamıştır. Bu
çalışmanın amacı, p-PKG uygulanan hastalarda KMN riski için MHR öngörü değerini
araştırmaktır.



Hastalar ve
Yöntem:
STEMİ tanısı ile hastaneye yatırılan ve p-PKG uygulanan
2120 hasta retrospektif olarak değerlendirildi. Kontrast maruziyeti sonrası 72
saat içinde başlangıç serum kreatininde ≥ %25 göreceli artış veya ≥ 0.5 mg/dL
mutlak artış olması KMN olarak tanımlandı. MHR acil servis başvurusunda
hesaplandı. KMN riski ile MHR arasındaki ilişki değerlendirildi.



Bulgular: KMN insidansı (n= 139) %6.6 idi. Yaş (p= 0.001), bazal kreatinin (p<
0.001), DM (p< 0.001), HT (p< 0.001), anemi (p= 0.001) KMN olan
hastalarda daha yüksekti. Hastalar CIN gelişimine göre iki gruba ayrıldı.
Periferik monosit sayısı, HDL ve MHR gruplar arasında farklılık yoktu. Tüm
temel karıştırıcı faktörler için düzeltme yapıldıktan sonra, periferik monosit
sayısı ve MHR bizim çok değişkenli lojistik regresyon analizi sonrasında KMN
gelişmesinin bağımsız belirleyicileri olarak saptanmadı.



Sonuç: MHR infarktüsün erken
safhasında stabil hastalardan çok farklı olmadığından, p-PKG uygulanan STEMİ
hastalarında KMN gelişimi için potansiyel belirleyicisi olarak
değerlendirilemez.

References

  • 1. Han Y, Jing J, Tu S, Tian F, Xue H, Chen W, et al. ST elevation acute myocardial infarction accelerates non-culprit coronary lesion atherosclerosis. Int J Cardiovasc Imaging 2014;30:253-61.
  • 2. Jarai R, Dangas G, Huber K, Xu K, Brodie BR, Witzenbichler B, et al. B-type natriuretic peptide and risk of contrast-induced acute kidney injury in acute ST-segmente elevation myocardial infarction a substudy from the HORIZONS-AMI trial. Circ Cardiovasc Interv 2012;5:813-20.
  • 3. Canpolat U, Çetin EH, Cetin S, Aydin S, Akboga MK, Yayla C, et al. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic inflammation. Clin Appl Thromb Hemost 2016;22:476-82.
  • 4. Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol 2014;46:1619-25.
  • 5. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999;130:461-70.
  • 6. Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:2889-934.
  • 7. Mehran R, Nikolsky E. Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney Int Suppl 2006;S11-5.
  • 8. McCullough PA. Contrast-induced acute kidney injury. J Am Coll Cardiol 2008;51:1419-28.
  • 9. Ruparelia N, Digby JE, Jefferson A, Medway DJ, Neubauer S, Lygate CA, et al. Myocardial infarction causes inflammation and leukocyte recruitment at remote sites in the myocardium and in the renal glomerulus. Inflamm Res 2013;62:515-25.
  • 10. Kielar ML, John R, Bennett M, Richardson JA, Shelton JM, Chen L, et al. Maladaptive role of IL-6 in ischemic acute renal failure. J Am Soc Nephrol 2005;16:3315-25.
  • 11. Karasawa K, Asano K, Moriyama S Ushiki M, Monya M, Iida M, et al. Vascular-resident CD169-positive monocytes and macrophages control neutrophil accumulation in the kidney with ischemia-reperfusion injury. J Am Soc Nephrol 2015;26:896-906.
  • 12. Fenyo IM, Gafencu AV. The involvement of the monocytes/macrophages in chronic inflammation associated with atherosclerosis, Immunobiology 2013;218:1376-84.
  • 13. Wong PC, Li Z, Guo J, Zhang A. Pathophysiology of contrast-induced nephropathy. Int J Cardiol 2012;158:186-92.
  • 14. Chen YL, Fu NK, Xu J, Yang SC, Li S, Liu YY, et al. A simple preprocedural score for risk of contrast-induced acute kidney injury after percutaneous coronary intervention. Catheter Cardiovasc Interv 2014;83:E8-16.
  • 15. Liu YH, Liu Y, Chen JY, Zhou YL, Chen ZJ, Yu DQ, et al. LDL cholesterol as a novel risk factor for contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention. Atherosclerosis 2014;237:453-9.
  • 16. Karabacak M, Kahraman F, Sert M, Celik E, Adali MK, Varol E, et al. Increased plasma monocyte chemoattractant protein-1 levels in patients with isolated low high-density lipoprotein cholesterol. Scand J Clin Lab Invest 2015;75:327-32.
  • 17. Navab M, Imes SS, Hama SY, Hough GP, Ross LA, Bork RW, et al. Monocyte transmigration induced by modification of low density lipoprotein in cocultures of human aortic wall cells is due to induction of monocyte chemotactic protein 1 synthesis and is abolished by high density lipoprotein. J Clin Invest 1991;88:2039-46.
  • 18. Kalil RS, Wang JH, de Boer IH, Mathew RO, Ix JH, Asif A, et al. Effect of extended-release niacin on cardiovascular events and kidney function in chronic kidney disease: a post hoc analysis of the AIM-HIGH trial. Kidney Int 2015;87:1250-7.
  • 19. Lu W, Tang Y, Zhang Z, Zhang X, Yao Y, Fu C, et al. Inhibiting the mobilization of Ly6C (high) monocytes after acute myocardial infarction enhances the efficiency of mesenchymal stromal cell transplantation and curbs myocardial remodeling. Am J Transl Res 2015;7:587-97.
  • 20. Ruparelia N, Godec J, Lee R, Chai JT, Dall’Armellina E, McAndrew D, et al. Acute myocardial infarction activates distinct inflammation and proliferation pathways in circulating monocytes, prior to recruitment, and identified through conserved transcriptional responses in mice and humans. Eur Heart J 2015;36:1923-34.
  • 21. Wheeler JG, Mussolino ME, Gillum RF, Danesh J. Associations between differential leucocyte count and incident coronary heart disease: 1764 incident cases from seven prospective studies of 30.374 individuals. Eur Heart J 2004;25:1287-92.
  • 22. Rogacev KS, Cremers B, Zawada AM, Seiler S, Binder N, Ege P, et al. CD14++CD16+ monocytes independently predict cardiovascular events: a cohort study of 951 patients referred for elective coronary angiography. J Am Coll Cardiol 2012;60:1512-20.
  • 23. Abaci O, Arat Ozkan A, Kocas C Cetinkal G, Sukru Karaca O, Baydar O, et al. Impact of Rosuvastatin on contrast-induced acute kidney injury in patients at high risk for nephropathy undergoing elective angiography. Am J Cardiol 2015;115:867-71.

Predictive Value of Monocyte to High-Density Lipoprotein Cholesterol Ratio for Contrast-Induced Nephropathy in Patients with ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention

Year 2017, Volume: 20 Issue: 1, 13 - 18, 03.04.2017

Abstract

Introduction: Contrast-induced
nephropathy (CIN) is a serious complication in patients with ST segment
elevation myocardial infarction (STEMI) undergoing primary percutaneous
coronary intervention (p-PCI). The monocyte to high-density lipoprotein (HDL)
cholesterol ratio (MHR) has recently been defined as an inflammation and
oxidative stress marker. The aim of this study was to evaluate the predictive
value of MHR for risk of CIN in patients with ST who underwent p-PCI.



Patients and Methods:
Data
of a 2120 patients who were hospitalised with the diagnosis of STEMI and
underwent p-PCI were retrospectively evaluated. A relative increase in serum
creatinine levels of ≥ 25% or an absolute increase of ≥ 0.5 mg/dL from the
baseline within 72 h of contrast exposure was defined as CIN. MHR was calculated
on emergency admission. The risk of CIN was evaluated across MHR values.



Results: The
incidence of CIN was 6.6% (n= 139). Age (p= 0.001), baseline creatinine levels
(p< 0.001), DM (p< 0.001), HT (p< 0.001) and anaemia (p= 0.001) were
higher in patients with CIN. The patients were divided into 2 groups based on
the development of CIN. Peripheral monocyte count, HDL levels and MHR did not
differ between the groups. After correction for all baseline confounders,
neither peripheral monocyte count nor MHR were found to be independent
predictors of CIN development in our multivariate logistic regression analyses.



Conclusion: Because MHR does not differ
much from that in stable patients at the early phase of infarction, it cannot
be a potential predictor of CIN development in patients with STEMI who
underwent p-PCI.

References

  • 1. Han Y, Jing J, Tu S, Tian F, Xue H, Chen W, et al. ST elevation acute myocardial infarction accelerates non-culprit coronary lesion atherosclerosis. Int J Cardiovasc Imaging 2014;30:253-61.
  • 2. Jarai R, Dangas G, Huber K, Xu K, Brodie BR, Witzenbichler B, et al. B-type natriuretic peptide and risk of contrast-induced acute kidney injury in acute ST-segmente elevation myocardial infarction a substudy from the HORIZONS-AMI trial. Circ Cardiovasc Interv 2012;5:813-20.
  • 3. Canpolat U, Çetin EH, Cetin S, Aydin S, Akboga MK, Yayla C, et al. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic inflammation. Clin Appl Thromb Hemost 2016;22:476-82.
  • 4. Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol 2014;46:1619-25.
  • 5. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999;130:461-70.
  • 6. Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:2889-934.
  • 7. Mehran R, Nikolsky E. Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney Int Suppl 2006;S11-5.
  • 8. McCullough PA. Contrast-induced acute kidney injury. J Am Coll Cardiol 2008;51:1419-28.
  • 9. Ruparelia N, Digby JE, Jefferson A, Medway DJ, Neubauer S, Lygate CA, et al. Myocardial infarction causes inflammation and leukocyte recruitment at remote sites in the myocardium and in the renal glomerulus. Inflamm Res 2013;62:515-25.
  • 10. Kielar ML, John R, Bennett M, Richardson JA, Shelton JM, Chen L, et al. Maladaptive role of IL-6 in ischemic acute renal failure. J Am Soc Nephrol 2005;16:3315-25.
  • 11. Karasawa K, Asano K, Moriyama S Ushiki M, Monya M, Iida M, et al. Vascular-resident CD169-positive monocytes and macrophages control neutrophil accumulation in the kidney with ischemia-reperfusion injury. J Am Soc Nephrol 2015;26:896-906.
  • 12. Fenyo IM, Gafencu AV. The involvement of the monocytes/macrophages in chronic inflammation associated with atherosclerosis, Immunobiology 2013;218:1376-84.
  • 13. Wong PC, Li Z, Guo J, Zhang A. Pathophysiology of contrast-induced nephropathy. Int J Cardiol 2012;158:186-92.
  • 14. Chen YL, Fu NK, Xu J, Yang SC, Li S, Liu YY, et al. A simple preprocedural score for risk of contrast-induced acute kidney injury after percutaneous coronary intervention. Catheter Cardiovasc Interv 2014;83:E8-16.
  • 15. Liu YH, Liu Y, Chen JY, Zhou YL, Chen ZJ, Yu DQ, et al. LDL cholesterol as a novel risk factor for contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention. Atherosclerosis 2014;237:453-9.
  • 16. Karabacak M, Kahraman F, Sert M, Celik E, Adali MK, Varol E, et al. Increased plasma monocyte chemoattractant protein-1 levels in patients with isolated low high-density lipoprotein cholesterol. Scand J Clin Lab Invest 2015;75:327-32.
  • 17. Navab M, Imes SS, Hama SY, Hough GP, Ross LA, Bork RW, et al. Monocyte transmigration induced by modification of low density lipoprotein in cocultures of human aortic wall cells is due to induction of monocyte chemotactic protein 1 synthesis and is abolished by high density lipoprotein. J Clin Invest 1991;88:2039-46.
  • 18. Kalil RS, Wang JH, de Boer IH, Mathew RO, Ix JH, Asif A, et al. Effect of extended-release niacin on cardiovascular events and kidney function in chronic kidney disease: a post hoc analysis of the AIM-HIGH trial. Kidney Int 2015;87:1250-7.
  • 19. Lu W, Tang Y, Zhang Z, Zhang X, Yao Y, Fu C, et al. Inhibiting the mobilization of Ly6C (high) monocytes after acute myocardial infarction enhances the efficiency of mesenchymal stromal cell transplantation and curbs myocardial remodeling. Am J Transl Res 2015;7:587-97.
  • 20. Ruparelia N, Godec J, Lee R, Chai JT, Dall’Armellina E, McAndrew D, et al. Acute myocardial infarction activates distinct inflammation and proliferation pathways in circulating monocytes, prior to recruitment, and identified through conserved transcriptional responses in mice and humans. Eur Heart J 2015;36:1923-34.
  • 21. Wheeler JG, Mussolino ME, Gillum RF, Danesh J. Associations between differential leucocyte count and incident coronary heart disease: 1764 incident cases from seven prospective studies of 30.374 individuals. Eur Heart J 2004;25:1287-92.
  • 22. Rogacev KS, Cremers B, Zawada AM, Seiler S, Binder N, Ege P, et al. CD14++CD16+ monocytes independently predict cardiovascular events: a cohort study of 951 patients referred for elective coronary angiography. J Am Coll Cardiol 2012;60:1512-20.
  • 23. Abaci O, Arat Ozkan A, Kocas C Cetinkal G, Sukru Karaca O, Baydar O, et al. Impact of Rosuvastatin on contrast-induced acute kidney injury in patients at high risk for nephropathy undergoing elective angiography. Am J Cardiol 2015;115:867-71.
There are 23 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Investigations
Authors

Regayip Zehir

Ahmet İlker Tekkeşin This is me

Nahide Haykır This is me

Yalçın Velibey This is me

Edibe Betül Börklü This is me

Ayça Gümüşdağ This is me

Publication Date April 3, 2017
Published in Issue Year 2017 Volume: 20 Issue: 1

Cite

Vancouver Zehir R, Tekkeşin Aİ, Haykır N, Velibey Y, Börklü EB, Gümüşdağ A. Predictive Value of Monocyte to High-Density Lipoprotein Cholesterol Ratio for Contrast-Induced Nephropathy in Patients with ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention. Koşuyolu Heart Journal. 2017;20(1):13-8.