0495 : Prediction and prognostic values of biomarkers of contrast induced acute kidney injury in ST-segment elevetaion myocardial infarction treated by primary percutaneous coronary intervention - 05/05/16
, Vincent Spagnoli, Mathieu Kerneis, Gilles Montalescot, Johanne Silvain, Jean-Philippe ColletRésumé |
Background and aims |
Contrast-induced acute kidney injury (CI-AKI) occurring during ST-segment elevated myocardial infarction (STEMI) is associated with a high morbidity and mortality. In a setting of systematic primary percutaneous coronary intervention (pPCI) in STEMI patients, we evaluate the predicting value and prognosis value in mortality of cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) in the incidence of CI-AKI.
Methods |
NGAL and cystatin-C level were measured on arrival to the cathlab prior to primary PCI in 701 STEMI patients and were correlated to the occurrence of CI-AKI according to the various existing definitions. Association between biomarkers level and the incidence of CI-AKI, MACE and allcause mortality at 1-year-follow-up were evaluated. Biomarkers were added to clinical data into a multivariate model analysis to evaluate their additive diagnosis and prognosis value.
Results |
Incidence of AKI varied from 12.0% to 21.5% depending of the definition. When divided in tertiles, levels of plasmatic NGAL and cystatin C were associated with a stepwise increase in the incidence of AKI and the stage of renal failure. Both biomarkers significantly predicted CI-AKI with receiver operating characteristic (ROC) analysis showing an area under curve of 0.60 for cystatin C, and 0.62 for NGAL, both p < 0.05.
MACCE and all-cause mortality at 1-year-follow-up were also higher in the higher tertile for both biomarkers (p value <0.01) (see figure).
Conclusions |
In myocardial infarction, NGAL and cystatin C are correlated with the incidence and severity of AKI, and occurrence of MACCE and all cause mortality at one year.
Abstract 0495 – Figure: K-M curves for all-cause death at 1 year
Abstract 0495 – Figure: K-M curves for all-cause death at 1 year
The author hereby declares no conflict of interest
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Vol 8 - N° 3
P. 200 - avril 2016 Retour au numéro
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