Background Few studies have investigated the role of serum uric acid （SUA） on the risk of contrast-in- duced nephropathy（CIN） in patients with acute coronary syndrome （ACS） after emergent percutaneous coronary i...Background Few studies have investigated the role of serum uric acid （SUA） on the risk of contrast-in- duced nephropathy（CIN） in patients with acute coronary syndrome （ACS） after emergent percutaneous coronary intervention（PCI）. The present study was conducted to investigate the relationship between hyperuricemia （HUA） and CIN in patients after emergent PCI. Methods A total of 558 consecutive patients with ACS undergoing emergent PCI in Fujian Provincial Hospital were enrolled in this study. Patients were divided into hyperuricemic group （n=136） and normouricemic group （n=422）. Hyperuricemia was defined as SUA 〉420 μmol/L for male, 〉 360 txmol/L for female. CIN was defined as an absolute ≥44.2 μmol/L（0.5 mg/dL） increase inthe serum creati- nine （SCr） level within 72 hours after contrast medium exposure. In hospital incidences of CIN and the major adverse cardiac events were compared between the two groups. The relationship between the incidence of CIN and HUA was evaluated by multivariate logistic regression analysis. Results Among the 558 patients, CIN was observed in 34（6.1%） patients, and incidence of CIN was significantly higher in the HUA group than in the normou- ricemic group [13.2% （18/136） vs. 3.8%（16/422）, P 〈 0.001]. SUA concentration was significantly higher in CIN group compared with that in non - CIN group [ （490.21±76.48 μmol/L） vs. （307.00±65.37μmol/L）, P 〈 0.001]. Need for renal replacement therapy （RRT）, congestive heart failure （CHF）, in hospital mortality after PCI were significantly higher in the HUA group compared with Normouricemic group （all P〈0.05）. Patients who devel- oped CIN had higher in hospital mortality [44.1% （15/34） vs. 2.9 % （15/524）, P 〈 0.001 ]. Multivariate analysis in- dicates that HUA（OR=3.020, 95% CI： 1.3340- 6.805, P 〈 0.001）, Intra- aortic balloon pump （IABP） use （OR= 15.724,95% CI： 3.913-63.179, P 〈 0.001） and Perioperative hypotension（OR=3.342, 95% CI�展开更多
Background Few studies have investigated the safe limits of total intravenous plus oral hydration to prevent contrast-induced nephropathy （CIN）. The present study was conducted to evaluate the effects of different c...Background Few studies have investigated the safe limits of total intravenous plus oral hydration to prevent contrast-induced nephropathy （CIN）. The present study was conducted to evaluate the effects of different composite hydration rate （intravenous plus oral） on CIN prevention in patients undergoing emergent percutaneous coronary intervention （PCI）. Methods This was a retrospective observational study that included 307 eligible patients, who were stratified into quartiles of rate of the composite hydration volumn to body weight and time （HV/ W/T）. CIN was defined as an absolute≥0.5 mg/dL or a relative ≥25% increase in the serum creatinine level within 72 hours after the procedure. Results In terms of risks of CIN, there were no statistical differences among individuals in four groups with different composite HV/W/T （27.6%, 19.0%, 23.0%, and 26.9% respectively in quartiles Q1, Q2, Q3, and Q4, P=0.565）. Additionally, higher composite hydration ratio seemed not to decrease the risk of in-hospital death, worsening heart failure and stroke （all P〉0.05）. After adjusting for other risk factors, multivariate analysis showed no statistical difference between Q2, Q3 or Q4, compared with Q1 （Q2 vs. QI： adjusted odds ratio [OR], 0.67, P=0.383; Q3 vs QI： adjusted OR, 0.77, P=0.550; Q4 vs. QI： adjusted OR, 0.75, P= 0.489）. Conclusion Excessive composite hydration may not provide supplemental benefit of CIN prevention and in-hospital outcomes in patients following emergent PCI, and moderate and prophylactic hydration is warranted.展开更多
基金supported by the Youth project of Fujian provincial health and Family Planning Commission(No.2015-1-9)
文摘Background Few studies have investigated the role of serum uric acid （SUA） on the risk of contrast-in- duced nephropathy（CIN） in patients with acute coronary syndrome （ACS） after emergent percutaneous coronary intervention（PCI）. The present study was conducted to investigate the relationship between hyperuricemia （HUA） and CIN in patients after emergent PCI. Methods A total of 558 consecutive patients with ACS undergoing emergent PCI in Fujian Provincial Hospital were enrolled in this study. Patients were divided into hyperuricemic group （n=136） and normouricemic group （n=422）. Hyperuricemia was defined as SUA 〉420 μmol/L for male, 〉 360 txmol/L for female. CIN was defined as an absolute ≥44.2 μmol/L（0.5 mg/dL） increase inthe serum creati- nine （SCr） level within 72 hours after contrast medium exposure. In hospital incidences of CIN and the major adverse cardiac events were compared between the two groups. The relationship between the incidence of CIN and HUA was evaluated by multivariate logistic regression analysis. Results Among the 558 patients, CIN was observed in 34（6.1%） patients, and incidence of CIN was significantly higher in the HUA group than in the normou- ricemic group [13.2% （18/136） vs. 3.8%（16/422）, P 〈 0.001]. SUA concentration was significantly higher in CIN group compared with that in non - CIN group [ （490.21±76.48 μmol/L） vs. （307.00±65.37μmol/L）, P 〈 0.001]. Need for renal replacement therapy （RRT）, congestive heart failure （CHF）, in hospital mortality after PCI were significantly higher in the HUA group compared with Normouricemic group （all P〈0.05）. Patients who devel- oped CIN had higher in hospital mortality [44.1% （15/34） vs. 2.9 % （15/524）, P 〈 0.001 ]. Multivariate analysis in- dicates that HUA（OR=3.020, 95% CI： 1.3340- 6.805, P 〈 0.001）, Intra- aortic balloon pump （IABP） use （OR= 15.724,95% CI： 3.913-63.179, P 〈 0.001） and Perioperative hypotension（OR=3.342, 95% CI�
基金supported by Science and Technology Planning Project of Longyan city in Fujian province(No.2015LY33)
文摘Background Few studies have investigated the safe limits of total intravenous plus oral hydration to prevent contrast-induced nephropathy （CIN）. The present study was conducted to evaluate the effects of different composite hydration rate （intravenous plus oral） on CIN prevention in patients undergoing emergent percutaneous coronary intervention （PCI）. Methods This was a retrospective observational study that included 307 eligible patients, who were stratified into quartiles of rate of the composite hydration volumn to body weight and time （HV/ W/T）. CIN was defined as an absolute≥0.5 mg/dL or a relative ≥25% increase in the serum creatinine level within 72 hours after the procedure. Results In terms of risks of CIN, there were no statistical differences among individuals in four groups with different composite HV/W/T （27.6%, 19.0%, 23.0%, and 26.9% respectively in quartiles Q1, Q2, Q3, and Q4, P=0.565）. Additionally, higher composite hydration ratio seemed not to decrease the risk of in-hospital death, worsening heart failure and stroke （all P〉0.05）. After adjusting for other risk factors, multivariate analysis showed no statistical difference between Q2, Q3 or Q4, compared with Q1 （Q2 vs. QI： adjusted odds ratio [OR], 0.67, P=0.383; Q3 vs QI： adjusted OR, 0.77, P=0.550; Q4 vs. QI： adjusted OR, 0.75, P= 0.489）. Conclusion Excessive composite hydration may not provide supplemental benefit of CIN prevention and in-hospital outcomes in patients following emergent PCI, and moderate and prophylactic hydration is warranted.
