We aimed to investigate the relationship between platelet-to-lymphocyte ratio (PLR) and contrast-induced acute kidney injury (CI-AKI) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). A total of 2563 patients diagnosed with STEMI and underwent primary pPCI were retrospectively included in the study. Levels of PLR and creatinine were measured before and at 72 hours after pPCI. Patients were divided into 2 groups: non-CI-AKI group and CI-AKI group. Contrast-induced acute kidney injury occurred in 6.4% of the overall study population. Patients in the CI-AKI group had significantly higher PLR than those in the non-CI-AKI group (169.18 ± 81.01 vs 149.49 ± 74.54, P < .001). In logistic regression analysis, PLR was an independent predictor of CI-AKI (odds ratio [OR]: 1.774, 95% CI: 1.243-2.532, P = .002), along with age, use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prior to the procedure, preprocedural creatinine level, amount of contrast material used during the procedure, and hypertension. Increased PLR levels are independently associated with a greater risk of CI-AKI in patients undergoing primary PCI for STEMI.
We evaluated whether primary percutaneous coronary intervention (pPCI) during off-hours is related to an increased incidence of contrast-induced nephropathy (CIN). We retrospectively analyzed the incidence of CIN mortality among 2552 patients with consecutive ST-segment elevation myocardial infarction treated with pPCI during regular hours (weekdays 8:00 am to 5:00 pm) and off-hours (weekdays 5:01 pm to 7:59 am, weekends and holidays). Patients in the off-hour group were more frequently admitted with acute heart failure symptoms (16.4% vs 7.8%, P < .001) and more contrast was injected during the procedure (235.2 ± 82.3 vs 248.9 ± 87.1 mL, P = .002). The frequency of CIN between on-hour and off-hour groups was similar (7.1% vs 6.2%, P = .453), but there was a trend toward higher in-hospital mortality when pPCI was performed during off-hours (1.9% vs 0.7%, P = .081). Off-hour pPCI was not associated with an increased risk of CIN (odds ratio: 1.051, P = .833). The incidence of CIN did not increase during off-hours, and off-hour pPCI is not a risk factor for CIN, despite an apparent increase in contrast media use during off-hour pPCI.
Aim: Monocyte to high-density lipoprotein cholesterol ratio (MHR) has recently emerged as a predictor of cardio-cerebrovascular diseases. Since around one-fifth of strokes are linked to atherosclerosis carotid artery, we aimed to present the relationship between carotid artery disease (CAD) and MHR value in acute ischemic stroke (AIS). Materials & methods: A total of 209 adult AIS patients analyzed. Patients divided into two groups in respect to the existence of CAD. MHR was compared between the two groups. Results: MHR with a cut off of 17.23 predicted the presence of disease in the carotid artery, with a sensitivity of 91.9% and specificity of 66.7. MHR was the independent predictor for the presence of disease in the carotid artery. Conclusion: MHR was found to be an independent predictor for the CAD in AIS. Therefore, in AIS patients with high MHR value, CAD should be examined more carefully.
Background: Development of contrast-induced acute kidney injury (CI-AKI) in patients with ST-elevation myocardial infarction (STEMI) treated via primary percutaneous coronary intervention (PCI) is a major cause of morbidity and mortality worldwide. The neutrophil-to-lymphocyte ratio (NLR), which is a marker of inflammation, has been demonstrated to be associated with the development of major adverse cardiovascular outcomes in many studies. From this point of view, in this study, we aimed to evaluate the predictive value of the NLR as regards the occurrence of CI-AKI in patients with STEMI undergoing primary PCI.
Methods: This study was conducted at Dr. Siyami Ersek Training and Research Hospital from May 2008 to June 2016. A total of 2000 patients with STEMI treated via primary PCI were enrolled in the study. The NLR was calculated as the ratio of the number of neutrophils to the number of lymphocytes. All venous blood samples were obtained within 8 hours after admission. CI-AKI was the primary end point of the study. Then, the relationship between CI-AKI and the NLR was assessed.
Results: CI-AKI was detected in 148 (7.4%) patients. The patients who developed CI-AKI had a significantly higher NLR than those who did not (7.08±4.43 vs. 6.18±3.98; P=0.011). In the multivariate logistic regression analyses, the NLR remained a significant independent predictor of CI-AKI (OR: 1.78, 95% CI: 1.21–2.61, and P=0.003).
Conclusion: The NLR may be a significant independent predictor of CI-AKI in patients with STEMI treated via primary PCI and higher NLR values could be independently associated with a greater risk for CI-AKI.
J Teh Univ Heart Ctr 2019;14(2):59-66
This paper should be cited as: Tanık VO, Çınar T, Velibey Y, Öz A, Kalenderoğlu K, Gümüşdağ A, Aruğaslan E, Keskin M, Eren M. Neutrophil-to-Lymphocyte Ratio Predicts Contrast-Induced Acute Kidney Injury in Patients with ST-Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention. J Teh Univ Heart Ctr 2019;14(2):59-66.
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