Impact of chronic total occlusion in a non-infarct-related coronary artery on contrast-associated nephropathy in acute ST-elevation myocardial infarction

Gok M., KURTUL A., TAYLAN G., Ozturk C., ÇAKIR B., Yılmaz E., ...Daha Fazla

Acta Cardiologica, cilt.78, sa.1, ss.118-123, 2023 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 78 Sayı: 1
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1080/00015385.2022.2085357
  • Dergi Adı: Acta Cardiologica
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE
  • Sayfa Sayıları: ss.118-123
  • Anahtar Kelimeler: chronic total occlusion, Contrast-associated nephropathy, non-infarct-related artery, primary percutaneous coronary intervention, ST-segment elevation myocardial infarction
  • Hatay Mustafa Kemal Üniversitesi Adresli: Evet

Özet

Objectives: Co-existing chronic total occlusion (CTO) in a non-infarct-related artery (IRA) might serve as an important trigger of adverse outcomes in ST-segment elevation myocardial infarction (STEMI). Therefore, we planned to analyse the potential impact of non-IRA CTO on the evolution of contrast-associated nephropathy (CAN) in STEMI patients managed with primary percutaneous coronary intervention (P-PCI). Methods: A total of 537 subjects with STEMI undergoing P-PCI during the first 12 h after the onset of their symptoms were enrolled in this retrospective study. The subjects were categorised based on the angiographic presence of non-IRA CTO. Moreover, the subjects were also divided into 2 groups based on their CAN status following P-PCI (CAN (+) and CAN (−)). Results: Co-existing non-IRA CTO was demonstrated in 86 subjects (16%). During the hospitalisation period, we identified 81 (15.1%) subjects with CAN. Subjects with non-IRA CTO had a significantly higher incidence of CAN compared with those without (56 [12.4%] vs 25 [29.1%], respectively, p < 0.001). In a logistic regression analysis, an existing non-IRA CTO (odds ratio: 2.840, 95%CI: 1.451–5.558, p = 0.002), as well as age, haemoglobin, diabetes mellitus, creatinine, and white blood cell count, were independent of predictors of CAN. Conclusion: In STEMI patients managed with P-PCI, a co-existing non-IRA CTO had an independent association with the evolution of CAN.