Koroner anjiyografi uygulanan hastalarda serum endokan düzeyleri ile kontrast kaynaklı nefropati varlığı arasındaki ilişki

Amaç: Kontrast kaynaklı nefropati (KİN), koroner anjiyografi (KAG) uygulanan hastalarda yüksek mortalite ve morbidite ile ilişkilidir. Yeni bir endotelyal disfonksiyon biyomarkeri olan Endocan, KİN için potansiyel bir immünoenflamatuar biyobelirteç olabilir. KAG uygulanan hastalarda, serum endokan düzeyleri ile KİN arasındaki olası ilişkinin araştırılması amaçlandı. Gereç ve Yöntemler: KAG yapılan 92 hasta çalışmaya alındı. KAG öncesinde, hastane başvurusunda her hastanın serum endokan düzeyleri değerlendirildi. Kontrast kaynaklı nefropati, maruziyetten 48-72 saat sonrasındaki kreatinin düzeyinin başlangıç serum kreatinin düzeyine göre % 25 veya 0.5 mg / dl artış olması olarak tanımlandı. Bulgular: Toplam 32 hastada (%34.8) KİN saptandı. KİN olan ve olmayan 2 grup arasında demografik veriler ve genel risk faktörleri açısından anlamlı fark saptanmadı.38 hastaya (%41) perkutanöz koroner girişim yapıldı. KİN saptanan hastalarda serum endokan düzeyleri (3.68 ng/dl;IQR, 0.78-17.3 karşı 1.81 ng/dl;IQR, 0.19-17.4, p: 0,002) KİN olmayan hastalara göre daha yüksek bulundu. Ek olarak; bazal glomerüler filtrasyon hızı, kontrast volümü, serum endokan ve sol ventrikül ejeksiyon fraksiyonu KİN için bağımsız risk faktörü olarak saptandı (p= 0.014, B: 0.94, CI: 0.89-0.98, p= 0.024, B: 2.55, CI: 1.13-5.77, p= 0.026, B: 2.45, CI: 1.11-5.42, p= 0.044, B: 0.91, CI: 0.83-1.43, sırasıyla). Sonuç: KAG yapılan hastalarda, yüksek serum endokan seviyeleri KİN oluşma riski ile ilişkili olabilir.

Anahtar Kelimeler:

endokan, kontrast ilişkili nefropati, endotelyal disfonksiyon

The relationship between serum endocan levels with the presence of contrast-induced nephropathy in patients undergoing coronary angiography

Aim:Contrast-induced nephropathy (CIN) is associated high mortality and morbidity risks in the patients undergoing coronary angiography (CAG).Endocan, a new endothelial dysfunction biomarker, could be a potential immunoinflammatory biomarker for CIN.We investigated the possible association between serum endocan levels and CIN in the patients undergoing CAG. Material and Methods:We prospectively enrolled 92 patients undergoing CAG.For each patient, serum endocan levels were assessed at hospital admission before CAG.Contrast-induced nephropathy was defined as an increase in serum creatinine 25% or 0.5 mg/dl from baseline in the first 48 - 72 hours. Results:Overall, 32 cases (34.8%) of CIN were diagnosed.There were no significant differences between the two groups (CIN and without-CIN) in demographic data and general risk factors. 38 patients (41%) were performed percutaneous coronary intervention. Patients with CIN had higher serum endocan levels (3.68 ng/dl;IQR, 0.78-17.3 vs 1.81 ng/dl;IQR, 0.19-17.4, p:0,002) than patients without CIN. Additionaly; basal glomerular filtration rate, contrast volume, serum endocan level and left ventricle ejection fraction were detected as independent risk factors of CIN (p= 0.014, B:0.94, CI: 0.89-0.98, p= 0.024, B:2.55, CI:1.13-5.77, p= 0.026, B:2.45, CI:1.11-5.42, p= 0.044, B:0.91, CI:0.83-1.43, respectively). Conclusion:In patients undergoing CAG, high serum endocan levels could be associated with an increased risk for CIN.

Keywords:

endocan, contrast-induced nephropathy, endothelial dysfunction,

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