Elevated serum fibrinogen levels and risk of contrast-induced acute kidney injury in patients undergoing a percutaneous coronary intervention for the treatment of acute coronary syndrome.
OBJECTIVE
Contrast-induced acute kidney injury (CI-AKI) is a common complication of diagnostic and therapeutic catheterizations, especially in the setting of acute coronary syndrome (ACS). Fibrinogen is a well-known cardiovascular risk factor. We evaluated whether serum fibrinogen level is associated independently with CI-AKI in patients with ACS who underwent a percutaneous coronary intervention (PCI).


METHODS
Patients (n=710, aged 61 ± 13, 69% men) were classified into two groups: CI-AKI and non-CI-AKI. CI-AKI was defined as an increase of at least 0.5 mg/dl or at least 25% in the serum creatinine level within 72 h following PCI.


RESULTS
CI-AKI occurred in 75 (10.6%) patients. We found significantly higher serum fibrinogen levels in patients who developed CI-AKI than in those who did not (498 ± 152 vs. 386 ± 96 mg/dl, P<0.001). Multivariate logistic regression analysis showed that serum fibrinogen level (odds ratio 1.006, 95% confidence interval 1.003-1.009, P<0.001), age, glomerular filtration rate, female sex, and white blood cell count were correlated with the development of CI-AKI.


CONCLUSIONS
Serum fibrinogen level is associated independently with a higher risk of CI-AKI in patients with ACS undergoing PCI.
Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
Ibrahim E
IE
Celik
Alparslan
A
Kurtul
Mustafa
M
Duran
Mikail
M
Yarlioglues
Deniz
D
Elcik
Alparslan
A
Kilic
Cemal
C
Koseoglu
Fatih
F
Oksuz
Sani N
SN
Murat
D054058:Acute Coronary Syndrome / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D058186:Acute Kidney Injury / Q000097:blood* / Q000139:chemically induced / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods; D004562:Electrocardiography; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology
D015415:Biomarkers; D003287:Contrast Media; D005340:Fibrinogen