Akut miyokard infarktüsünde trombosit/lenfosit oranı kontrast nefropatisini öngörür

Amaç: Kontrast madde nefropatisi (CIN) uzamış hastanede yatış süresi, artmıs kardiyovasküler komplikasyonlar ve mortalite ile ilişkilidir. Trombosit/lenfosit oranı (PLR) tromboz ve inflamasyon arasındaki dengeyi gösteren potansiyel bir belirteç olarak tanımlanmış ve artan kardiyovasküler morbidite ve mortalite ile ilişkili bulunmuştur. Biz bu çalışmada PLR’nin primer perkütan koroner girişim (pPCI) yapılan ST yükselmeli miyokard infarktüsü (STEMI) hastalarda CIN gelişimini tahmin etmede bağımsız bir risk faktörü olup olmadığı araştırdık.Gereç ve Yöntemler: Kurumumuza akut STEMI ile başvuran ve pPCI yapılan 1348 hasta geriye dönük olarak değerlendirildi. Hastane dosya ve bilgisayar kayıtlarından veriler elde edildi. CIN gelişimi sonlanım noktası olarak kabul edildi.Bulgular: 127 (%9.4) hastada CIN gelişmişti. 16 hastaya renal replasman tedavisi uygulandı. Hastane içi mortalite oranı %2,7(n = 37) bulunmuştur. Hastalar CIN gelişimine göre iki gruba ayrıldı. Yaş (P = 0,001), bazal GFR (P < 0,001), grade 3 ve üzeri kronik böbrek hastalığı (P < 0,001), bazal kreatinin (P < 0,001), EF (P < 0,001), DM varlığı (P < 0,001) gruplar arasında farklı idi. Çok değişkenli analizlerde, PLR (odds ratio [OR] 1.012, %95 güven aralığı [CI] 1,006-1,017, P < 0,001) CIN gelişimini bağımsız olarak öngördü. Sonuçlar: PLR, kolay ulaşılabilir yaygın olarak kullanılan ve nispeten ucuz biyomarkerdir ve STEMI nedeniyle pPCI uygulanan hastalarda CIN gelişiminin bağımsız bir belirleyicisidir.

Anahtar Kelimeler:

Trombosit/lenfosit oranı, ST yükselmeli miyokard infarktüsü, kontrast madde nefropatisi

Platelet-to-lymphocyte ratio predicts contrast-induced nephropathy in acute myocardial infarction

Aim: Contrast-induced nephropathy (CIN) is responsible for an increased mortality rate and correlates with increases in hospital stays and the risk of cardiovascular complications. The platelet to lymphocyte ratio (PLR) was introduced as a potential marker to determine the balance between thrombosis and inflammation and was associated with increased cardiovascular morbidity and mortality. We investigated whether PLR on admission is an independent risk factor that predicts the development of CIN in patients with ST-segment elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (pPCI).Material and Methods: 1348 consecutive patients with acute STMI who were admitted to our institution and underwent pPCI were retrospectively evaluated. Data obtained from hospital files and computer records. CIN development was accepted as the endpoint.Results: A total of 127 (9.4%) patients experienced CIN. 16 patients underwent renal replacement theraphy. In-hospital mortality rate was found 2.7% (n = 37). Patients were divided into two groups based on development of CIN. Age (P = 0.001), baseline GFR (P < 0.001), grade 3 and more chronic kidney disease (P < 0.001), baseline creatinin (P < 0.001), EF (P < 0.001), presence of DM (P < 0.001) were different between groups. In multivariate analyses, PLR (odds ratio [OR] 1.012, 95% confidence interval [CI] 1.006-1.017, P < 0.001) was independently predicted CIN development. Conclusion: PLR is easily available, widely used, and relatively cheap biomarker, and is an independent predictor of CIN development in patients with STEMI undergoing pPCI.

Keywords:

Platelet/lymphocyte ratio, ST-segment elevation acute myocardial infarction, contrast-induced nephropathy,

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