title: A correlation between acute kidney injury and myonecrosis after scheduled percutaneous coronary intervention.
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 5×99th 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.
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
authors.forename: Hao-yu
authors.initials: HY
authors.lastname: Meng
authors.forename: Ying-ming
authors.initials: YM
authors.lastname: Zhao
authors.forename: Zhi-wen
authors.initials: ZW
authors.lastname: Tao
authors.forename: Xiao-xuan
authors.initials: XX
authors.lastname: Gong
authors.forename: Ze-mu
authors.initials: ZM
authors.lastname: Wang
authors.forename: Bo
authors.initials: B
authors.lastname: Chen
authors.forename: Zheng-xian
authors.initials: ZX
authors.lastname: Tao
authors.forename: Chun-jian
authors.initials: CJ
authors.lastname: Li
authors.forename: Tie-bing
authors.initials: TB
authors.lastname: Zhu
authors.forename: Lian-sheng
authors.initials: LS
authors.lastname: Wang
authors.forename: Zhi-jian
authors.initials: ZJ
authors.lastname: Yang
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000150:complications / Q000628:therapy; D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D000368:Aged; D000419:Albuminuria / Q000150:complications; D003287:Contrast Media / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D009336:Necrosis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011446:Prospective Studies; D012307:Risk Factors; D019210:Troponin I / Q000097:blood; D020107:Troponin T / Q000097:blood
chemical_list: D003287:Contrast Media; D019210:Troponin I; D020107:Troponin T; D003404:Creatinine
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