0495 : Prediction and prognostic values of biomarkers of contrast induced acute kidney injury in ST-segment elevetaion myocardial infarction treated by primary percutaneous coronary intervention

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• 作者：Lee Nguyen ; ^{lee.nguyen@lrb.aphp.fr" class="auth_mail" title="E-mail the corresponding author} ; Vincent Spagnoli ; Mathieu Kerneis ; Gilles Montalescot ; Johanne Silvain ; Jean-Philippe Collet
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：8
• 期：3
• 页码：200
• 全文大小：101 K

文摘

Contrast-induced acute kidney injury (CI-AKI) occurring during ST-segment elevated myocardial infarction (STEMI) is associated with a high morbidity and mortality. In a setting of systematic primary percutaneous coronary intervention (pPCI) in STEMI patients, we evaluate the predicting value and prognosis value in mortality of cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) in the incidence of CI-AKI.

Methods

NGAL and cystatin-C level were measured on arrival to the cathlab prior to primary PCI in 701 STEMI patients and were correlated to the occurrence of CI-AKI according to the various existing definitions. Association between biomarkers level and the incidence of CI-AKI, MACE and allcause mortality at 1-year-follow-up were evaluated. Biomarkers were added to clinical data into a multivariate model analysis to evaluate their additive diagnosis and prognosis value.

Results

Incidence of AKI varied from 12.0% to 21.5% depending of the definition. When divided in tertiles, levels of plasmatic NGAL and cystatin C were associated with a stepwise increase in the incidence of AKI and the stage of renal failure. Both biomarkers significantly predicted CI-AKI with receiver operating characteristic (ROC) analysis showing an area under curve of 0.60 for cystatin C, and 0.62 for NGAL, both p < 0.05.

MACCE and all-cause mortality at 1-year-follow-up were also higher in the higher tertile for both biomarkers (p value <0.01) (see figure).

Conclusions

In myocardial infarction, NGAL and cystatin C are correlated with the incidence and severity of AKI, and occurrence of MACCE and all cause mortality at one year.

The author hereby declares no conflict of interest