Monocyte to High-Density Lipoprotein Ratio Predicts Contrast-Induced Nephropathy in Patients With Acute Coronary
Taner Ulus1, Kamal Isgandarov1, Ahmet Serdar Yilmaz1
11 Department of Cardiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
Insights
The monocyte to high-density lipoprotein ratio (MHR) can predict contrast-induced nephropathy (CIN) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). Early MHR assessment aids in identifying high-risk individuals for CIN.
Area of Science:
- Cardiology
- Nephrology
- Biomarkers
Background:
- Contrast-induced nephropathy (CIN) worsens prognosis in acute coronary syndrome (ACS) patients.
- Early identification of CIN risk is crucial for intervention and improved outcomes.
- Inflammation, indicated by novel markers like monocyte to high-density lipoprotein ratio (MHR), plays a role in CIN development.
Purpose of the Study:
- To evaluate the predictive role of preprocedural monocyte to high-density lipoprotein ratio (MHR) for contrast-induced nephropathy (CIN) in ACS patients undergoing percutaneous coronary intervention (PCI).
- To assess the relationship between bleeding events and CIN using the thrombolysis in myocardial infarction (TIMI) classification.
Main Methods:
- A study included 647 patients with ACS who underwent PCI.
- Data collected included patient demographics, comorbidities, contrast volume, estimated glomerular filtration rate (eGFR), and preprocedural MHR.
- Development of CIN was assessed, and independent predictors were identified through statistical analysis.
Main Results:
- Seventy patients (10.8%) developed CIN.
- Independent predictors for CIN included age, diabetes mellitus, contrast volume, eGFR, and MHR.
- Preprocedural MHR was identified as a significant predictor of CIN.
Conclusions:
- Preprocedural MHR serves as a simple and effective marker for predicting CIN in ACS patients undergoing PCI.
- Utilizing MHR can facilitate early identification of high-risk patients, enabling timely implementation of protective strategies.
- Further research may explore MHR's role in conjunction with bleeding risk assessment.
Abstract:
Contrast-induced nephropathy (CIN) is associated with worse prognosis in patients with acute coronary syndrome (ACS). Early identification and intervention for patients with a high risk of CIN are very important to improve clinical outcomes. Inflammation plays important role in the development of CIN in the setting of ACS. The monocyte to high-density lipoprotein ratio (MHR) is a novel inflammatory marker. Bleeding is also associated with worse prognosis in such patients. We aimed to investigate whether the preprocedural MHR had a predictive role for CIN development in such patients. In addition, using the thrombolysis in myocardial infarction classification, we aimed to assess whether there was any relationship between bleeding and CIN. A total of 647 patients (496 males; age: 63.3 ± 12.7 years) with ACS who underwent percutaneous coronary intervention (PCI) were included in the study. Seventy patients (10.8%) had developed CIN. Age, diabetes mellitus, contrast volume, estimated glomerular filtration rate, and MHR were independent predictors for CIN. Preprocedural MHR may be used as a simple marker of CIN. It may help with the early identification of patients with ACS who underwent PCI who are at high risk of CIN thus allowing the planning of protective measures.
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