Wide pulse pressure as a novel predictor of contrast-induced acute kidney injury in diabetic patients undergoing primary percutaneous coronary intervention.
Cemalettin Yilmaz, Büşra Güvendi Şengör, Regayip Zehir, Ahmet Ferhat Kaya, Mehmet Hasan Özdil, Barkin Kültürsay
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引用次数: 0
Abstract
Background: Primary percutaneous coronary intervention (p-PCI) is pivotal in managing ST-segment elevation myocardial infarction (STEMI); however, it introduces potential risks, such as contrast-induced acute kidney injury (CI-AKI). This study aimed to investigate the relationship between pulse pressure (PP) and CI-AKI incidence in diabetic patients.
Methods: In this retrospective study conducted between 2021 and 2022, 590 diabetic STEMI patients undergoing p-PCI were categorized based on the presence of wide PP. Individuals with PP ≥ 65 mmHg were classified as the 'wide PP (+) group', while those with PP < 65 mmHg were classified as the 'wide PP (-) group'. To determine independent predictors of CI-AKI, multivariable logistic regression models were applied. After establishing the base model, blood pressure indices, including PP, SBP, DBP, mean arterial pressure, and pulsatility were added to the model using the stepwise selection method.
Results: Among the patients, 18.3% ( n = 108) were in the wide PP (+) group, while 81.7% ( n = 482) were in the wide PP (-) group. The incidence of hypertension, SBP, PP, and the risk of CI-AKI were higher in the wide PP (+) group. Multivariable analysis recognized PP, wide PP, and pulsatility as independent CI-AKI predictors [odds ratio (OR): 1.024, 95% confidence interval (CI): 1.003-1.045, P = 0.025; OR: 1.684, 95% CI: 1.025-2.769, P = 0.040; OR: 13.816, 95% CI: 2.069-92.245, P = 0.007, respectively].
Conclusion: Increased PP emerges as an independent predictor for CI-AKI in diabetic patients undergoing p-PCI.
期刊介绍:
Blood Pressure Monitoring is devoted to original research in blood pressure measurement and blood pressure variability. It includes device technology, analytical methodology of blood pressure over time and its variability, clinical trials - including, but not limited to, pharmacology - involving blood pressure monitoring, blood pressure reactivity, patient evaluation, and outcomes and effectiveness research.
This innovative journal contains papers dealing with all aspects of manual, automated, and ambulatory monitoring. Basic and clinical science papers are considered although the emphasis is on clinical medicine.
Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.