在导管室出现一过性低血压的急性冠状动脉综合征患者的急性肾损伤院内发生率

A. Pak, Inst Med Sci, Farrukh Malik, Asim Ali, R. Ullah, Z. Arain, Badr Mansoor, Muhammad Iqbal, Interventional Cardiology Fellow
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引用次数: 0

摘要

目的确定在导管室出现一过性低血压的急性冠状动脉综合征患者中急性肾损伤的院内发生率。研究方法:2022 年 10 月至 2023 年 3 月,卡拉奇国家心血管病研究所(NICVD)开展了一项基于医院的前瞻性研究。研究对象包括所有因急性冠状动脉综合征入院并在入院 72 小时内接受经皮冠状动脉介入治疗的成年患者,这些患者在手术过程中出现一过性低血压,术前肾功能正常,年龄在 18 岁至 75 岁之间,男性和女性均可。收集基线和临床数据,并使用 SPSS 22.0 版进行所有统计学检验,显著性水平(P 值)均小于 0.05。结果组群总人数为 290 人。急性肾损伤在 STEMI 患者中更为常见,为 57(19.6%)例,其次是 NSTEMI 18(6.2%)例和 UA 8(2.7%)例,但它们之间的关系并不显著,P = 0.71。在多变量二项式分析中,男性(OR = 2.49)、农村居民(OR = 0.25)、高血压患者(OR = 2.18)、糖尿病患者(OR = 9.37)、高脂血症患者(OR = 3.85)和 LVEF <50% 的患者(OR = 6.34)更容易发生急性肾损伤(P = <0.05)。结论在本研究中,大多数患者都出现了急性肾损伤,且发病率高于以往的研究。在所有风险因素中,LVEF <50%、2 型糖尿病和高脂血症是最常见的急性肾损伤风险因素。
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In-Hospital Incidence of Acute Kidney Injury Among Patients of Acute Coronary Syndrome Who Have Transient Hypotension in Catheterization Laboratory
Objective: To determine in-hospital incidence of acute kidney injury among patients of acute coronary syndrome who have transient hypotension in catheterization laboratory. Methodology: A prospective hospital-based study was conducted at National Institute of Cardiovascular Disease (NICVD), Karachi from October 2022 to March, 2023. All adult patients admitted with acute coronary syndrome and underwent percutaneous coronary intervention within 72 hours of admission and experienced transient hypotension during procedure, normal renal function before procedure, age between 18 years to 75 years, and both males and females were included in this study. Baseline and clinical data were collected, and all statistical tests were conducted with a level of significance (p-value) of <0.05 using SPSS Version 22.0. Results: The total cohort size consisted of 290 patients. Prevalence of acute kidney injury was more common in patients with STEMI 57(19.6%) followed by NSTEMI 18(6.2%), and UA 8(2.7%) but there is an insignificant association among them, p = 0.71. On multivariate binominal analysis, males (OR = 2.49), rural residents (OR = 0.25), hypertensives (OR = 2.18), diabetics (OR = 9.37), hyperlipidemia (OR = 3.85), and patients with LVEF <50% (OR = 6.34) were more likely to develop acute kidney injury (p = <0.05). Conclusion: In this study, majority of the patients experienced acute kidney injury and prevalence in our study is higher than previously conducted studies. Among all risk factors, LVEF <50%, type 2 diabetes mellitus, and hyperlipidemia were most prevalent risk factors of AKI.
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