Predictive value of admission D-dimer for contrast-induced acute kidney injury and poor outcomes after primary percutaneous coronary intervention.

ABSTRACT: BACKGROUND:DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI. METHODS:We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic (ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ?0.3?mg/dl or a relative increase in serum creatinine ?50% within 48?h of contrast medium exposure. RESULTS:Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ?g/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUCDD?=?0.729 vs AUCMehran?=?0.722; p?=?0.8298). Multivariate logistic regression analysis indicated that DD >?0.69 ?g/ml was an independent predictor of CI-AKI (odds ratio [OR]?=?3.37,95% CI:1.80-6.33, p??0.69 ?g/ml was associated with an increased risk of long-term mortality during a mean follow-up period of 16?months (hazard ratio?=?3.41, 95%CI:1.4-8.03, p?=?0.005). CONCLUSION:Admission DD >?0.69 ?g/ml was a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.

SUBMITTER: Lin KY 

PROVIDER: S-EPMC7063708 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature