Correlation Between Plasma NT-proBNP Levels And Contrast Induced Nephropathy In Patients With Acute Myocardial Infarction

Objective:To investigate the relationship between preoperative NT-proBNP level and the incidence of contrast induced nephropathy in patients with AMI after PCI,to study the predictive value of NT-proBNP level on CIN after PCI operation.Methods:In this study,423 patients with AMI who received PCI treatment in our heart medicine deparment from January 2012 to December 2015 were selected to study.The serum NT-proBNP levels of all patients were measured by electrochemical luminescence method before PCI.The coronary angiography was performed in all patients with Iodine sea alcohol of low permeability nonionic contrast agent.Before and after 12h PCI,all patients were treated with 0.9%sodium chloride.The relationship between preoperative serum NT-proBNP level and the incidence of CIN was observed.Results:In this study,CIN occurred in 52 patients of 423 patients,and the incidence was 12.29%.According to whether the occurrence of CIN,patients were divided into CIN group with 52 cases and non CIN group with 371 cases.There were not statistically significant in Sex,high-fat hyperlipidemia,smoking,drinking,ACEI/ARB,diuretics,beta blockers,statins and other drug medication history,coronary artery lesion number,adjuvant,hemoglobin,total cholesterol,triglyceride,low density lipoprotein,blood creatinine,stent number,stent implantation total length,dosage of contrast agent and operation time between two groups(p>0.05).The difference in age,hypertension,diabetes,systolic blood pressure,diastolic blood pressure,LVEF,Killips heart function classification,NT-proBNP was statistically significant between two groups(p<0.05).Multi factor Logistic regression analysis with the occurrence of CIN as the dependent variable showed that age,LVEF<40%,NT-proBNP,diabetes and so on were the independent risk factors of CIN.The sensitivity,specificity,positive predictive value and negative predictive value,coincidence degree,the optimal cut-off value,AUC and 95%CI of NT-proBNP prediction were respectively 71.15%,77.90%,31.09%,95.07%,77.07%,1324.56pg/mL,0.793 and 0.727-0.849.Conclusion:Preoperative NT-proBNP levels has correlation with postoperative incidence rate of CIN,has certain predictive value with incidence rate of CIN,which is worth further research and discussion.