Elevated high-sensitivity C-reactive protein combined with procalcitonin predicts high risk of contrast-induced nephropathy after percutaneous coronary intervention

BMC Cardiovascular Disorders

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[1] 0000 0004 1804 3009, grid.452702.6, Department of Cardiology, Second Hospital of Hebei Medical University, No. 215 Hepingxi Road, 050000, Shijiazhuang, Hebei, China;

关键词: Contrast-induced nephropathy;    High-sensitivity C-reactive protein;    Hydration;    Procalcitonin;    Percutaneous coronary intervention;   

DOI  :  10.1186/s12872-019-1137-9

来源: publisher

【 摘 要 】

BackgroundContrast-induced nephropathy (CIN) is common after percutaneous coronary intervention (PCI) and always leads to a poor prognosis. Compared with conventional detection methods, either high-sensitivity C-reactive protein (hs-CRP) or procalcitonin have higher sensitivity and specificity for predicting CIN, but their combination has not been explored. This prospective study investigated the value of hs-CRP combined with procalcitonin for predicting CIN after PCI.MethodsAll patients undergoing PCI admitted to our hospital during the year 2016 were consecutively enrolled (n = 343). The patients received adequate hydration before PCI and 20 mg furosemide after the procedure. CIN was diagnosed by a 25% elevation in serum creatinine or ≥ 44.2 μmol/L (0.5 mg/dL) serum creatinine within 48 to 72 h after intravenous injection of contrast media.ResultsPatients with high hs-CRP or procalcitonin had higher rates of CIN relative to those patients with low values. For predicting CIN, hs-CRP combined with procalcitonin showed an area under the receiver operating characteristic curve of 0.67, with optimal cut-off value 0.0643610, and the sensitivity and specificity were higher than hs-CRP or procalcitonin alone. The logistic regression analysis showed that high-risk factors of CIN were acute myocardial infarction and highly elevated hsCRP and procalcitonin.ConclusionsPrior to PCI, an elevation of the inflammatory biomarkers hsCRP and procalcitonin are a risk factor for postoperative CIN. This study suggests that the combination of hsCRP and procalcitonin is a better predictor of CIN after PCI then either hsCRP or procalcitonin alone.Trial registration numberChiCTR-IOR-14005250. Date of registration 2014-09-24.

【 授权许可】

CC BY