机构:[1]Department of Cardiology, Dongguan TCM Hospital, Dongguan 523000, China[2]The First School of Clinical Medicine, Guangdong Medical University, Zhanjiang 523808, China[3]Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China广东省人民医院[4]Department of Cardiology, Shunde Hospital of Southern Medical University, Shunde, Guangzhou, China
Background. Contrast-associated acute kidney injury (CA-AKI) is a common complication in patients undergoing coronary angiography (CAG). However, few studies demonstrate the association between the prognosis and developed CA-AKI in the different periods after the operation. Methods. We retrospectively enrolled 3206 patients with preoperative serum creatinine (Scr) and at least twice SCr measurement after CAG. CA-AKI was defined as an increase >= 50% or >= 0.3 mg/dL from baseline in the 72 hours after the procedure. Early CA-AKI was defined as having the first increase in SCr within the early phase (<24 hours), and late CA-AKI was defined as an increase in SCr that occurred for the first time in the late phase (24-72 hours). The first endpoint of this study was long-term all-cause mortality. Kaplan-Meier analysis was used to count the cumulative mortality, and the log-rank test was used to assess differences between curves. Univariate and multivariate cox regression analyses were performed to assess whether patients who developed different type CA-AKI were at increased risk of long-term mortality. Results. The number of deaths in the 3 groups was 407 for normal (12.7%), 106 for early CA-AKI (32.7%) and 57 for late CA-AKI (17.7%), during a median follow-up period of 3.95 years. After adjusting for important clinical variables, early CA-AKI (HR = 1.33, 95% CI: 1.02-1.74, P = 0.038) was significantly associated with mortality, while late CA-AKI (HR = 0.92, 95% CI: 0.65-1.31, P = 0.633) was not. The same results were found in patients with coronary artery disease, chronic kidney disease, diabetes mellitus, and percutaneous coronary intervention. Conclusions. Early increases in Scr, i.e., early CA-AKI, have better predictive value for long-term mortality. Therefore, in clinical practice, physicians should pay more attention to patients with early renal injury related to long-term prognosis and give active treatment.
基金:
+is study was supported by grants from the
Beijing Lisheng Cardiovascular Health Foundation and
Guangdong Provincial People’s Hospital Foundation (no.
LHJJ20141751), Progress in Science and Technology Project
of Guangzhou (grant no. 201904010470), the Science and
Technology Planning Project of Guangzhou (grant no.
201704020124), and Dengfeng Project in Guangdong
Province (DFJH201919 and DFJH2020026).
第一作者机构:[1]Department of Cardiology, Dongguan TCM Hospital, Dongguan 523000, China[2]The First School of Clinical Medicine, Guangdong Medical University, Zhanjiang 523808, China[3]Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
共同第一作者:
通讯作者:
推荐引用方式(GB/T 7714):
Lun Zhubin,Liu Jin,Liu Liwei,et al.Association of Early and Late Contrast-Associated Acute Kidney Injury and Long-Term Mortality in Patients Undergoing Coronary Angiography[J].JOURNAL OF INTERVENTIONAL CARDIOLOGY.2021,2021:doi:10.1155/2021/6641887.
APA:
Lun, Zhubin,Liu, Jin,Liu, Liwei,Liang, Jingjing,Chen, Guanzhong...&Ye, Jianfeng.(2021).Association of Early and Late Contrast-Associated Acute Kidney Injury and Long-Term Mortality in Patients Undergoing Coronary Angiography.JOURNAL OF INTERVENTIONAL CARDIOLOGY,2021,
MLA:
Lun, Zhubin,et al."Association of Early and Late Contrast-Associated Acute Kidney Injury and Long-Term Mortality in Patients Undergoing Coronary Angiography".JOURNAL OF INTERVENTIONAL CARDIOLOGY 2021.(2021)