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- Title
Akut Koroner Sendrom Hastalarında Perkütan Koroner Girişim Sonrası Kontrast Nefropatisi için Risk Sınıflandırmasında FIB-4 İndeksi.
- Authors
DURAK, Üyesi Hüseyin; ÇETİN, Mustafa; ÖZYILDIZ, Ali Gökhan; EMLEK, Nadir; ERGÜL, Üyesi Elif; DUMAN, Hakan
- Abstract
Objective: Coronary imaging and procedures using contrast media are necessary for patients with acute coronary syndromes (ACS), but some patients may develop contrast induced nephropathy (CIN) after the use of contrast, which may prolong hospitalisation and worsen outcomes. A liver fibrosis marker (FIB-4 index) is associated with new-onset chronic kidney disease in ACS, ischemic heart disease, heart failure, subclinical atherosclerosis, and renal function decline. This study aimed to investigate the relationship between the FIB-4 index and CIN in patients with ACS who underwent coronary intervention (PCI). Material and Method: 288 ACS patients had FIB-4 index calculated, PCI performed, and serum creatinine levels measured daily, during 72 hours after PCI. CIN development recorded, divided into CIN+, CIN- groups. Results: 50 out of 288 patients developed CIN, with a higher mean age, FIB-4 index, Mehran Score, serum creatinine, C-reactive protein level, and hypertension rate in the CIN (+) group. The CIN (+) group exhibited lower estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF), and hemoglobin levels, along with a significantly lower smoking rate compared to the CIN (-) group. FIB-4 score ≥1.5 had 76% sensitivity and 41% specificity for CIN. The FIB-4 index and Mehran Score had similar accuracy in predicting CIN development, with an AUC of 0.643 and 0.638, respectively. The FIB-4 index (hazard ratio (HR):1.242, 95% confidence interval (CI): 1.075-1.435, p=0.003) and Mehran Score (OR: 1.043, 95% CI 1.012-1.074, p=0.006) were independently associated with the CIN (+) group. Conclusion: The FIB-4 index predicted CIN development in ACS patients undergoing PCI. It's a cost-free tool to estimate and prevent CIN before imaging and interventional procedures.
- Subjects
CONTRAST induced nephropathy; ACUTE coronary syndrome; MYOCARDIAL ischemia; HEPATIC fibrosis; CORONARY disease
- Publication
MN Cardiology / MN Kardiyoloji, 2024, Vol 31, Issue 3, p85
- ISSN
1300-4778
- Publication type
Article