Background Contrast induced nephropathy（CIN） is associated with increased mortality. serum creatinine（sCr） and serum cystatin C（sCys C） have diagnostic value for CIN in patients taking coronary angiography（CAG...Background Contrast induced nephropathy（CIN） is associated with increased mortality. serum creatinine（sCr） and serum cystatin C（sCys C） have diagnostic value for CIN in patients taking coronary angiography（CAG）. However, whether sCys C is superior to sCr is still controversial. Methods All 280 patients undergoing PCI from July 2015 to July 2017 in Shunde Hospital, Southern Medical University were enrolled in this prospective study. The plasma levels of sCr and sCys C were measured in fasting blood samples in the morning before angiography and at 48 hours and 72 hours after the procedure. Receiver operating characteristic curve（ROC）analysis was performed for sCr and sCys C 48 hours after procedure. Results According to sCys C criteria, CIN occurred in 85 patients（30.4%） after contrast exposure, while, CIN occurred in 22 patients（7.9%）. ROC curve analysis found that AUC for sCr and sCys C was 0.741（P〈0.05, 95% CI = 0.613-0.869） and 0.720（P〈0.05, 95%CI = 0.590-0.851）, respectively without significantly different（P=0.412）. Conclusion The sCys C is not superior to s Cr for predicting CIN in angiography patients.展开更多
Background Totally radial access(TRA) is getting popular in coronary chronic total occlusion(CTO) percutaneous coronary intervention(PCI). but it has been associated with a non-negligible risk of complications. Method...Background Totally radial access(TRA) is getting popular in coronary chronic total occlusion(CTO) percutaneous coronary intervention(PCI). but it has been associated with a non-negligible risk of complications. Methods This retrospective study included 1760 CTO patients underwent PCI from January 2015 to January 2018.Patients were divided into two groups: TRA group was referred to single radial or double radial access;Femoral access(FA) group was referred to single FA, double FA, FA and RA. The primary efficacy endpoint was procedural success, which was defined as technical success without in-hospital MACE. The primary safety endpoint was a composite of vascular complications and major bleeding. Results TRA was applied in 482 cases, while FA in 1278 cases. Mean J-CTO scores was higher in FA group(2.5±1.0 vs. 2.0±0.9, P=0.001). Procedural success showed no significant difference between both groups(82.9% vs. 83.6%, P=0.823). The primary safety endpoint was higher in FA group(11.4 vs. 4.1%, P<0.001). On multivariate analysis, FA approach was independently associated with the primary safety endpoint [odds ratio;(OR) 2.887, 95% confidence interval(CI) 1.759-4.739,P=0.001], after adjusting for age, diabetes, body mass index, prior CABG, and J-CTO score. Conclusions TRA for CTO PCI might be associated with lower incidence of a composite endpoint of vascular complications and major bleeding, while maintaining similarly high success rates.[S Chin J Cardiol 2019;20(4):211-216]展开更多
基金supported by the Medical scientific research projects of science and technology bureau of Foshan,Guangdong,China(No.2015AB001963)
文摘Background Contrast induced nephropathy（CIN） is associated with increased mortality. serum creatinine（sCr） and serum cystatin C（sCys C） have diagnostic value for CIN in patients taking coronary angiography（CAG）. However, whether sCys C is superior to sCr is still controversial. Methods All 280 patients undergoing PCI from July 2015 to July 2017 in Shunde Hospital, Southern Medical University were enrolled in this prospective study. The plasma levels of sCr and sCys C were measured in fasting blood samples in the morning before angiography and at 48 hours and 72 hours after the procedure. Receiver operating characteristic curve（ROC）analysis was performed for sCr and sCys C 48 hours after procedure. Results According to sCys C criteria, CIN occurred in 85 patients（30.4%） after contrast exposure, while, CIN occurred in 22 patients（7.9%）. ROC curve analysis found that AUC for sCr and sCys C was 0.741（P〈0.05, 95% CI = 0.613-0.869） and 0.720（P〈0.05, 95%CI = 0.590-0.851）, respectively without significantly different（P=0.412）. Conclusion The sCys C is not superior to s Cr for predicting CIN in angiography patients.
基金supported by the Science and Technology Innovation Project from Foshan,Guangdong(No.FS0AA-KJ218-1301-0010)
文摘Background Totally radial access(TRA) is getting popular in coronary chronic total occlusion(CTO) percutaneous coronary intervention(PCI). but it has been associated with a non-negligible risk of complications. Methods This retrospective study included 1760 CTO patients underwent PCI from January 2015 to January 2018.Patients were divided into two groups: TRA group was referred to single radial or double radial access;Femoral access(FA) group was referred to single FA, double FA, FA and RA. The primary efficacy endpoint was procedural success, which was defined as technical success without in-hospital MACE. The primary safety endpoint was a composite of vascular complications and major bleeding. Results TRA was applied in 482 cases, while FA in 1278 cases. Mean J-CTO scores was higher in FA group(2.5±1.0 vs. 2.0±0.9, P=0.001). Procedural success showed no significant difference between both groups(82.9% vs. 83.6%, P=0.823). The primary safety endpoint was higher in FA group(11.4 vs. 4.1%, P<0.001). On multivariate analysis, FA approach was independently associated with the primary safety endpoint [odds ratio;(OR) 2.887, 95% confidence interval(CI) 1.759-4.739,P=0.001], after adjusting for age, diabetes, body mass index, prior CABG, and J-CTO score. Conclusions TRA for CTO PCI might be associated with lower incidence of a composite endpoint of vascular complications and major bleeding, while maintaining similarly high success rates.[S Chin J Cardiol 2019;20(4):211-216]
