Primer Perkütan Koroner Girişim Uygulanan Hastalarda Serum Prokalsitonin Düzeyi ile Kontrast Nefropatisi Arasındaki İlişki

Abstract

Objective:We aimed to investigate the relationship between serum procalcitonin level and contrast-induced nephropathy (CIN) in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI). Material and Methods: Three hundred forty-one consecutive STEMI patients (mean age: 57±11 years; 67.1% male) who underwent PPCI in our clinic between April 2013 and December 2013 were studied. CIN was defined as an increase in serum creatinine concentration ≥ 25% over baseline. Biochemical tests, including determination of serum procalcitonin level, were performed before (baseline) and 48 h after PPCI. Results: Of 341 study patients, 96 (28.2%) developed CIN. The median (interquartile range) baseline procalcitonin level was significantly higher in the CIN (+) group [0.075 μg/L (0.70-1.20 μg/L) versus 0.05 μg/L (0.75-1.00 μg/L), p<0.001)]; however, high procalcitonin was not an independent predictor of CIN in multivariate logistic regression analysis (p=0.274). On the other hand, high serum C-reactive protein level (odds ratio: 1.02 [1.01-1.04], p=0.002), high amount of contrast media used (odds ratio 1.12 [1.08-1.17], p<0.001), and low rate of post-procedural thrombolysis in myocardial infarction (TIMI) grade 3 flow (odds ratio 0.05 [0.01-0.49], p=0.01) were identified as independent predictors of CIN. Conclusion: Serum procalcitonin level does not have a clear association with CIN; however, underlying reasons for the higher serum procalcitonin levels in patients who developed CIN need to be explored with further studies.