| Background:With the development of medical technology,angiography and percutaneous coronary intervention(PCI)are more and more widely used,and the incidence of contrast induced acute kidney injury(CI-AKI)is increasing.Once CI-AKI occurs,the length of stay,medical expenses,clinical adverse events and long-term mortality of patients will increase significantly,so it is very important to predict the occurrence of CI-AKI earlier.Objective:The purpose of this study was to analyze the predictive value of serum NT-pro BNP levels on admission for CI-AKI in STEMI patients undergoing emergency PCI.Methods:Patients with ST-segment elevation myocardial infarction undergoing emergency percutaneous coronary intervention and were treated with isotonic contrast agent iodixanol was performed in the catheter room of the heart center of Liaoning Provincial People’s Hospital from January 1,2019 to December 31,2020 were retrospectively analyzed.According to the inclusion and exclusion criteria,a total of 150 patients were collected and divided into two groups according to whether CI-AKI occurred or not.There were 26 patients in CI-AKI group and 124 patients in non CI-AKI group.1.The patients’ personal general and clinical data were counted,including gender,age,smoking history,complications(hypertension,diabetes),heart rate,systolic and diastolic blood pressures on admission,serum NT-pro BNP levels on admission,left ventricular ejection fraction(LVEF),uric acid,total cholesterol,hemoglobin,peak value of creatine kinase isoenzyme(CK-MB),peak value of troponin T(TNT),duration of disease(The time from onset to urgent PCI),operation time,dose of contrast agent,number of diseased vessels,main diseased vessels and other basic information.2.SPSS26.0 statistical software was used for statistical description of the distribution of sample characteristics of the tested variables.Compared the differences of general data and clinical data between the two groups.Variables of P<0.05 in univariate analysis were included in multivariate Logistic regression analysis to identify independent risk factors for CI-AKI in STEMI patients undergoing emergency PCI.Receiver operating characteristic curve(ROC)was drawn to obtain area under the curve(AUC)and cut-off point,and evaluate the early predictive value of serum NT-pro BNP levels in the occurrence of CI-AKI in STEMI patients undergoing emergency PCI.Result:1.The incidence of CI-AKI in this study was 17.3%.2.The comparison of general data and clinical data between the two groups showed that the mean age of the CI-AKI group was higher than that of the non-CI-AKI group,and the difference was statistically significant(74.00±12.70 vs 65.90±11.19,P <0.001),Compared with non-CI-AKI group,the proportion of diabetes in CI-AKI group was higher(P < 0.05),In the CI-AKI group,the levels of admission NT-pro BNP was higher,while the levels of LVEF was lower(P < 0.05).There was no statistical difference between other general data and clinical data.3.Multivariate Logistic regression analysis showed that serum NT-pro BNP levels on admission(OR=1.348,95%CI:1.162-1.489,P<0.001)and diabetes(OR=3.713,95%CI:1.040-13.258,P=0.043)were independent risk factors for CI-AKI in STEMI patients undergoing emergency PCI.4.ROC curve analysis showed that the area under the curve(AUC)of serum NT-pro BNP levels on admission to predict the occurrence of CI-AKI in STEMI patients undergoing emergency PCI was 0.822,the cut-off value was 545pg/m L,the sensitivity was 69.2%,and the specificity was 94.4%(P < 0.001).Conclusion:1.In patients undergoing emergency PCI for STEMI,the serum NT-pro BNP levels on admission and diabetes were independent risk factors for the CI-AKI.2.The serum NT-pro BNP levels on admission can predict the occurrence of CI-AKI undergoing emergency PCI in STEMI patients.By assessing the serum NT-pro BNP levels on admission,it can further improve the clinical awareness of CI-AKI prevention,reduce the occurrence of CI-AKI,and improve the prognosis of patients after PCI treatment. |
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