Clinical Significance Of Early Biomarker In Contrast-induced Acute Kidney Injury After PCI

Objective:To explore the clinical significance of Early Biomarker in Contrast-induced Acute Kidney Injury (CIAKI) after PCI.Methods:200patients with established or non-ST elevation acute coronary syndromes patients were selected from Apr2013to Aug2013in the Cardiac Intensive Care Unit of Teda International Cardiovascular Hospital. All patients were given Iopromide. The age, sex, BMI, smoking history, old myocardial infarction, left ventricular ejection fraction, hypertension, glycuresis, hyperlipoidemia, reference vessel diameter, the total length of stent and the minimum stent diameter were documented accurately.The concentrations of serum creatinine (Scr), serum Cystatin C, plasma NGAL, urine NGAL and urine Kim-1were measure before and after surgery. According to AKI criteria, patients were divided into the CIAKI group and normal group. Dynamic changes of levels of these biomarkers in the two groups were observed. The area under the ROC curve (AUC) was used to evaluate the early diagnostic value of CIAKI.Results:1. There were16patients had CIAKI and the incidence rate of CIAKI was8.0%in200patients after PCI. Logistic regression test found that risk factors of CIAKI were hypertension and the dose of contrast agent.2.①There was no significant diferrence in these two groups before surgery.②In the CIAKI group, the level of biomarkers after surgery was significantly higher than those before the operation. And compared with normal group, the level of NGAL in the CIAKI group at2h after surgery was raised and reached the peak level at4h. The serum Cystatin C was raised compared with at4h after surgery, and urine NGAL was raised compared with at8h after surgery. And the urine Kim-1was raised at8h, and reached the peak level at24h.③According to the area under the ROC curve (AUC) of these biomarkers, we knew them which were earlier than Scr appeared in Contrast-induced Acute Kidney Injury (CIAKI) after PCI.Conclusion:1.Hypertension and the dose of contrast agent were risk factors of CIAKI after undergoing coronary angiography with percutaneous coronary intervention. 2.The biological markers of CIAKI after PCI are significantly increased after operation, and can provide new methods in the early diagnosis of AKI after PCI.