Study On Relationship Between Arterial Stiffness And CIN In Patients With ACS After PCI Therapy

Background:With the development of interventional treatment,clinical treatment of many common diseases such as coronary heart disease,peripheral vascular disease and tumor have better clinical efficacy and prognosis,but the attendant complications gradually incressed,contrast nephropathy(CIN)is one of them.At present,CIN has become the third leading cause of iatrogenic renal injury,accounting for about 12% of iatrogenic renal injury.CIN is a common complication after PCI,which can increase the risk of cardiovascular and renal adverse events,affect the quality of life of patients seriously,and increase long-term mortality.But there is no special treatment in clinic,so prevention is very important.The purpose of this study was to reveal the correlation between arterial stiffness and CIN after PCI.If it is established,it is possible to actively carry out antiatherosclerosis treatment before PCI procedure so as to reduce the occurrence of CIN,thereby reducing the economic burden of patients and society.Objective:According to the occurrence of CIN in patients with ACS after PCI procedure and the result of arterial stiffness examination and other clinic data,carried out a retrospectively analysis.To investigate the correlation between atherosclerosis and CIN,and to provide guidance for clinical prevention and treatment.Method:ACS patients underwent PCI procedure in the First Affiliated Hospital of Henan traditional Chinese Medical University and Henan Province People's Hospital from Jan.2016 to Jan.2017.According to the preoperative and postoperative serum creatinine levels in patients with PCI determine if the patients were CIN,and then the patients were divided into CIN group and non CIN group.The general data were recorded respectively,which is including gender,age,admission blood glucose,serum creatinine,admission admission e GFR value,LVEF value,dosage of contrast media,stents number,arterial stiffness(ba-PWV),and whether patients with hypertension or diabetes,smoking etc.The differences of arterial stiffness between the two groups were compared and analyzed.All statistics were analyzed by SPSS19.0 software package.Continuous variables according with normal distribution are presented as mean±SD and were compared using the t test for independent samples.The measurement data of non normal distribution were expressed as median or four quantiles,and rank sum test was used for comparison between groups.Categorical data are presented as rate or percentage and were compared using the Fisher exact test,as appropriate.Multivariate Logisitic regression analysis was used to estimate the relevance between acute hyperglycemia and the incidence of CIN after emergency percutaneous coronary interventional therapy,P<0.05 was considered statistically significant.ROC curve was used to analyze the sensitivity and specificity of PWV value in predicting the occurrence of CIN.And use the receiver–operator characteristic curve analyze the sensitivity and specificity and cutoff value for PWV to indicate the CIN.Results: 294 patients were included in this study,including 179 male and 115 female,with an average age of(61.2±6.9).And 40 paitients were found CIN,the incidence was 13.6%.The t test showed that the arterial stiffness in CIN group was significantly than that in non CIN group(P=0.019<0.05),the difference was statistically significant.At the same time,multivariate Logistitic regression analysis showed that increased arterial stiffness was an independent risk factor for CIN.And the cutoff value for PWV obtained by the receiver–operator characteristic curve analysis was 13.0 m/s for the prediction of CIN(95% confidence interval: 0.498-0.695,sensitivity: 85.0%,specificity:60.2%,AUC:0.596).Conclusions:1?The arterial stiffness in CIN group was significantly higher than that in non CIN group;2?Increased arterial stiffness was an independent risk factor for CIN after PCI in patients with ACS;...