Relationship between hyperuricemia and contrast-induced nephropathy in patients after emergent percutaneous coronary intervention

LIN Kai-yang; WU Zhi-yong; LIN Chun-jin; RUAN Jing-ming; JIANG Hui; GUO Yan-song; ZHU Peng-li

摘要：Background Few studies have investigated the role of serum uric acid (SUA) on the risk of contrast-induced nephropathy(CIN) in patients with acute coronary syndrome (ACS) after emergent percutaneous coronary intervention(PCI).The present study was conducted to investigate the relationship between hyperuricemia (HUA) and CIN in patients after emergent PCI.Methods A total of 558 consecutive patients with ACS undergoing emergent PCI in Fujian Provincial Hospital were enrolled in this study.Patients were divided into hyperuricemic group (n=136) and normouricemic group (n=422).Hyperuricemia was defined as SUA＞420 μmol/L for male,＞ 360 μmol/L for female.CIN was defined as an absolute ≥44.2 μmol/L(0.5 mg/dL) increase inthe serum creatinine(SCr) level within 72 hours after contrast medium exposure.In hospital incidences of CIN and the major adverse cardiac events were compared between the two groups.The relationship between the incidence of CIN and HUA was evaluated by multivariate logistic regression analysis.Results Among the 558 patients,CIN was observed in 34(6.1％) patients,and incidence of CIN was significantly higher in the HUA group than in the normouricemic group [13.2％(18/136) vs.3.8％(16/422),P ＜ 0.001].SUA concentration was significantly higher in CIN group compared with that in non-CIN group[(490.21 ± 76.48 μmol/L) vs.(307.00 ± 65.37 μmol/L),P ＜ 0.001].Need for renal replacement therapy (RRT),congestive heart failure (CHF),in hospital mortality after PCI were significantly higher in the HUA group compared with Normouricemic group (all P＜0.05).Patients who developed CIN had higher in hospital mortality[44.1％ (15/34) vs.2.9％ (15/524),P ＜ 0.001].Multivariate analysis indicates that HUA(OR=3.020,95％ CI:1.3340-6.805,P ＜ 0.001)、Intra-aortic balloon pump (IABP) use (OR=15.724,95％ CI:3.913-63.179,P ＜ 0.001) and Perioperative hypotension(OR=3.342,95％ CI:1.373-8.138,P ＜0.01) were predictors of CIN in patients after emergent percutaneous coronary intervention.Conclusion Hyperuricemia is the independent risk predictor of CIN in patients with ACS undergoing emergent PCI.