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Population attributable risk estimates of risk factors for contrast-induced acute kidney injury following coronary angiography: a cohort study

机译:冠状动脉血管造影术后癌症急性肾损伤危险因素的群体占危险因素的风险估计:群组研究

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摘要

Abstract Background Contrast-induced acute kidney injury (CI-AKI) is a common complication with poor outcomes following coronary angiography (CAG) or percutaneous coronary intervention (PCI). However, no study has explored the population attributable risks (PARs) of the CI-AKI risk factors. Therefore, we aimed to identify the independent risk factors of CI-AKI and estimate their PARs. Methods We analyzed 3450 consecutive patients undergoing CAG/PCI from a prospective cohort in Guangdong Provincial People’s Hospital. CI-AKI was defined as a serum creatinine elevation ≥50% or 0.3 mg/dL from baseline within the first 48 to 72 h after the procedure. Independent risk factors for CI-AKI were evaluated through stepwise approach and multivariable logistic regression analysis, and those that are potentially modifiable were of interest. PARs of independent risk factors were calculated with their odds ratios and prevalence among our cohort. Results The overall incidence of CI-AKI was 7.19% (n = 248), which was associated with increased long-term mortality. Independent risk factors for CI-AKI included heart failure (HF) symptoms, hypoalbuminemia, high contrast volume, hypotension, hypertension, chronic kidney disease stages, acute myocardial infarction and age > 75 years. Among the four risk factors of interest, the PAR of HF symptoms was the highest (38.06%), followed by hypoalbuminemia (17.69%), high contrast volume (12.91%) and hypotension (4.21%). Conclusions These modifiable risk factors (e.g., HF symptoms, hypoalbuminemia) could be important and cost-effective targets for prevention and treatment strategies to reduce the risk of CI-AKI. Intervention studies targeting these risk factors are needed.
机译:摘要背景对比剂急性肾损伤(CI-AKI)是与以下冠状动脉造影(CAG)或经皮冠状动脉介入治疗(PCI)预后不良的常见并发症。然而,没有研究探讨了CI-AKI危险因素的人群归因危险度(PAR灯)。因此,我们的目的是识别CI-AKI的独立危险因素,并估计它们的PAR灯。方法我们分析了连续3450例来自广东省人民医院一项前瞻性队列进行CAG / PCI。 CI-AKI被定义为血清肌酸酐升高≥50%或0.3毫克/分升的基线从手术后第48至72小时内。为CI-AKI的独立危险因素,通过逐步的方法和多因素Logistic回归分析进行了评价,并那些可能改变的是利益。的独立危险因素,PAR灯,用他们的胜算比和我们的队列中的患病率来计算。结果CI-AKI的发生率为7.19%(N = 248),其具有增加的长期死亡率相关联。为CI-AKI的独立危险因素包括心脏衰竭(HF)的症状,低蛋白血症,高对比度的量,低血压,高血压,慢性肾脏疾病阶段,急性心肌梗死,年龄> 75岁。其中感兴趣的四种风险因素,HF的PAR症状为最高(38.06%),其次是低蛋白血症(17.69%),高对比度的体积(12.91%)和低血压(4.21%)。结论:这些改变的危险因素(如HF症状,低蛋白血症)可能是重要的和具有成本效益目标的预防和治疗策略来减少CI-AKI的风险。需要针对这些危险因素的干预研究。

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