急性心肌梗死患者急诊PCI术后急慢性血糖比与急性肾损伤的关系

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung Pub Date : 2025-04-25 DOI:10.1016/j.hrtlng.2025.04.025

Yifan Deng , Yue Ma , Jiapei Gao , Qinyu Sun , Jing Zhang , Li Zhu

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引用次数: 0

摘要

造影剂诱导的急性肾损伤（CI-AKI）是急性心肌梗死患者接受经皮冠状动脉介入治疗（PCI）的常见并发症，且与不良预后相关。缺乏有效的预测性生物标志物和功能。目的探讨急诊PCI患者急慢性血糖比（ARC）与CI-AKI的相关性。方法本研究纳入2018年11月至2024年5月接受急诊PCI治疗的AMI患者。系统收集人口统计学特征、病史和围手术期实验室参数。通过最小绝对收缩和选择算子（LASSO）回归和多变量逻辑回归确定潜在的预测因子。限制三次样条（RCS）用于检验非线性关系，随后进行亚群分析和模态图构建。结果共纳入502例患者，术后发生CI-AKI 84例，非CI-AKI 418例。ARC是CI- aki的独立危险因素（OR = 1.06, 95% CI 1.04-1.08）。RCS分析显示ARC与CI-AKI呈非线性关系。在各种调整后的模型中，ARC作为一个连续变量与CI-AKI的发生存在相关性。在第三和第四分位数中，ARC与CI- aki风险独立相关（分别OR = 2.95, 95% CI 1.16-7.47和OR = 7.17, 95% CI 2.99-17.24）。基于LASSO回归的nomogram model对CI- aki有较好的预测精度（AUC = 0.831, 95% CI 0.778-0.884）。结论急性心肌梗死患者急诊PCI术后ARC与急性肾损伤风险呈非线性正相关。

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Association between acute-to-chronic glucose ratio and acute kidney injury after emergency PCI in patients with acute myocardial infarction

Background

Contrast-induced acute kidney injury (CI-AKI) is a common complication in patients with acute myocardial infarction undergoing Percutaneous coronary intervention (PCI) treatment and is associated with poor prognosis. there is a lack of effective predictive biomarkers and functions.

Objective

To explore the correlation between the acute-to-chronic blood glucose ratio (ARC) and CI-AKI in patients with emergency PCI.

Methods

This study enrolled AMI patients undergoing emergency PCI from November 2018 to May 2024. Demographic characteristics, medical history, and perioperative laboratory parameters were systematically collected. Potential predictors were identified through least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression. Restricted cubic splines (RCS) were employed to examine nonlinear relationships, with subsequent subgroup analyses and nomogram construction.

Results

A total of 502 patients were included, with 84 developing postoperative CI-AKI and 418 remaining non-CI-AKI. ARC was found to be an independent risk factor for CI-AKI (OR = 1.06, 95 % CI 1.04–1.08). RCS analysis revealed a non-linear relationship between ARC and CI-AKI. In various adjusted models, ARC as a continuous variable showed a correlation with CI-AKI occurrence. In the third and fourth quantiles, ARC was independently associated with CI-AKI risk (OR = 2.95, 95 % CI 1.16–7.47 and OR = 7.17, 95 % CI 2.99–17.24, respectively). The nomogram model, based on LASSO regression, demonstrated good predictive accuracy for CI-AKI (AUC = 0.831, 95 % CI 0.778–0.884).

Conclusion

There is a non-linear positive correlation between ARC and the risk of acute kidney injury after emergency PCI in patients with AMI.

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.