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Kidney Injury Molecule-1 Is Associated with Contrast-Induced Nephropathy in Elderly Patients with Non-STEMI
1Yeni Yuzyil University, Faculdade de Medicina, Departamento de Cardiologia, Istambul - Turquia.
Insights
Serum kidney injury molecule-1 (KIM-1) and Mehran score predict contrast-induced nephropathy (CIN) in elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI). Higher KIM-1 levels correlate with increased risk of major adverse cardiovascular events (MACE) post-procedure.
Area of Science:
- Nephrology
- Cardiology
- Biomarkers
Background:
- Contrast-induced nephropathy (CIN) is linked to major adverse cardiovascular events (MACE).
- Oxidative stress mechanisms are implicated in the development of CIN.
Purpose of the Study:
- To investigate the association between serum kidney injury molecule-1 (KIM-1) levels and CIN.
- To evaluate CIN predictors in elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI).
Main Methods:
- A cohort of 758 NSTEMI patients undergoing percutaneous coronary intervention (PCI) was studied.
- 15 patients developed CIN, compared to a matched control group of 104.
- Serum KIM-1, Mehran score, and clinical outcomes were assessed at baseline and up to 72 hours, with one-year follow-up.
Main Results:
- CIN occurred in 12.60% of patients.
- Serum KIM-1 and Mehran scores were significantly higher in the CIN group (p < 0.001 and p = 0.001, respectively).
- Major adverse cardiovascular events (MACE) were significantly more frequent in the CIN group (46.70% vs. 11.50%, p = 0.001).
Conclusions:
- Baseline serum KIM-1 concentration and Mehran score are independent predictors of CIN in elderly NSTEMI patients.
- The CIN group experienced significantly higher rates of mortality, cardiovascular death, myocardial reinfarction, stroke, and MACE at one-year follow-up.
Background:
Contrast-induced nephropathy (CIN) is associated with an increased risk of major adverse cardiovascular events (MACE), and the association between CIN and oxidative mechanisms is well documented.
Objective:
This study aimed to evaluate the relationship between serum levels of kidney injury molecule-1 (KIM-1) and CIN in elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI).
Methods:
This study included a total of 758 patients with NSTEMI, who underwent percutaneous coronary intervention (PCI); 15 developed CIN after PCI, and another 104 were the control group, matched for age > 65 years. Baseline to 48-to-72-hour laboratory values and clinical outcomes were recorded. Patients were followed during one year. P values of < 0.05 were considered significant.
Results:
CIN was observed in 12.60% of the patients. Serum KIM-1 was significantly higher in the CIN group than in the non-CIN group (14.02 [9.53 - 19.90] vs. 5.41 [3.41 - 9.03], p < 0.001). The Mehran score was significantly higher in the CIN group than in the non-CIN group (14 [5 - 22] vs. 5 [2 - 7], p = 0.001). MACE were significantly higher in the CIN group than in the non-CIN group (7 [46.70%] vs. 12 [11.50%], p = 0.001). Multivariate logistic regression analysis showed that baseline KIM-1 level (OR = 1.652, 95% CI: 1.20 - 2.27, p = 0.002) and Mehran score (OR = 1.457, 95% CI: 1.01 - 2.08, p = 0.039) were independent predictors of CIN in elderly patients with NSTEMI.
Conclusion:
Baseline serum KIM-1 concentration and Mehran score are independent predictors of CIN in elderly patients with NSTEMI. Additionally, all-cause mortality, cardiovascular death, myocardial reinfarction, stroke, and MACE were significantly higher in the CIN group at one-year follow-up. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0).
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