The Association of Serum Lactate Level with the Occurrence of Contrast-Induced Acute Kidney Injury and Long-Term Prognosis in Patients Undergoing Emergency Percutaneous Coronary Intervention
Gaoliang Yan, Dong Wang, Chengchun Tang, Genshan Ma Department of Cardiology, Zhongda Hospital of Southeast University Medical School, Nanjing, Jiangsu, People’s Republic of ChinaCorrespondence: Genshan MaDepartment of Cardiology, Zhongda Hospital of Southeast University Medical School, No. 87 Dingj...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Dove Medical Press
2021-07-01
|
Series: | International Journal of General Medicine |
Subjects: | |
Online Access: | https://www.dovepress.com/the-association-of-serum-lactate-level-with-the-occurrence-of-contrast-peer-reviewed-fulltext-article-IJGM |
id |
doaj-04cde2bc662d4e519abe7012ecf6b9cc |
---|---|
record_format |
Article |
spelling |
doaj-04cde2bc662d4e519abe7012ecf6b9cc2021-07-04T20:03:22ZengDove Medical PressInternational Journal of General Medicine1178-70742021-07-01Volume 143087309766502The Association of Serum Lactate Level with the Occurrence of Contrast-Induced Acute Kidney Injury and Long-Term Prognosis in Patients Undergoing Emergency Percutaneous Coronary InterventionYan GWang DTang CMa GGaoliang Yan, Dong Wang, Chengchun Tang, Genshan Ma Department of Cardiology, Zhongda Hospital of Southeast University Medical School, Nanjing, Jiangsu, People’s Republic of ChinaCorrespondence: Genshan MaDepartment of Cardiology, Zhongda Hospital of Southeast University Medical School, No. 87 Dingjiaqiao, Gulou District, Nanjing, Jiangsu, 210009, People’s Republic of ChinaTel/Fax +86 25 83262410Email Dr_magenshan@hotmail.comObjective: The association of lactate and contrast-induced acute kidney injury (CI-AKI) has not been well established. This prospective study was planned to identify the effects of lactate level on the occurrence of CI-AKI and long-term prognosis with acute myocardial infarction (AMI) patients undergoing emergency percutaneous coronary intervention (PCI).Methods: A total of 280 patients with AMI who underwent emergency PCI were selected from March 2018 to March 2019. A receiver operating characteristic (ROC) curve was used to analyze the optimal cut-off value of lactate on predicting CI-AKI after PCI. A multivariable logistic regression model was used to explore the significant predictors that might affect the occurrence of CI-AKI after univariate analysis. The primary endpoints were clinical outcomes including events: a combined endpoint of major adverse cardiovascular events, re-hospitalization due to heart failure, and worsening renal function. The Cox regression model was further used to analyze the predictors of the long-term prognosis after PCI.Results: Among the 280 patients, 64 patients (22.9%) developed CI-AKI after emergency PCI procedure. Multivariable logistic regression analysis revealed that baseline lactate level was the independent risk factor for the development of CI-AKI (OR, 3.657; 95% CI, 2.237– 5.978; p< 0.001). The area under the ROC curve for predicting CI-AKI of lactate was 0.786, and the optimum cut-off point of lactate was 3.02 mmol/L, with sensitivity of 65.6% and specificity of 85.2%. The incidence of primary endpoints in the high lactate group (lactate ≥ 3.02mmol/L) was significantly increased compared with the control group [26.3% (42/160) vs 15.8% (19/120), χ2=4.430, p=0.035]. Cox regression analysis also confirmed high lactate was an independent predictor for primary endpoint outcomes at 1-year follow-up (HR, 1.916; 95% CI, 1.118– 3.285; p=0.018).Conclusion: Our study demonstrates that baseline high lactate levels may be associated with an increased risk of CI-AKI and are the important predictors of long-term poor cardiorenal outcomes in AMI patients undergoing emergency PCI.Keywords: myocardial infarction, contrast media, acute kidney injury, lactate, percutaneous coronary intervention, prognosishttps://www.dovepress.com/the-association-of-serum-lactate-level-with-the-occurrence-of-contrast-peer-reviewed-fulltext-article-IJGMmyocardial infarctioncontrast mediaacute kidney injurylactatepercutaneous coronary interventionprognosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yan G Wang D Tang C Ma G |
spellingShingle |
Yan G Wang D Tang C Ma G The Association of Serum Lactate Level with the Occurrence of Contrast-Induced Acute Kidney Injury and Long-Term Prognosis in Patients Undergoing Emergency Percutaneous Coronary Intervention International Journal of General Medicine myocardial infarction contrast media acute kidney injury lactate percutaneous coronary intervention prognosis |
author_facet |
Yan G Wang D Tang C Ma G |
author_sort |
Yan G |
title |
The Association of Serum Lactate Level with the Occurrence of Contrast-Induced Acute Kidney Injury and Long-Term Prognosis in Patients Undergoing Emergency Percutaneous Coronary Intervention |
title_short |
The Association of Serum Lactate Level with the Occurrence of Contrast-Induced Acute Kidney Injury and Long-Term Prognosis in Patients Undergoing Emergency Percutaneous Coronary Intervention |
title_full |
The Association of Serum Lactate Level with the Occurrence of Contrast-Induced Acute Kidney Injury and Long-Term Prognosis in Patients Undergoing Emergency Percutaneous Coronary Intervention |
title_fullStr |
The Association of Serum Lactate Level with the Occurrence of Contrast-Induced Acute Kidney Injury and Long-Term Prognosis in Patients Undergoing Emergency Percutaneous Coronary Intervention |
title_full_unstemmed |
The Association of Serum Lactate Level with the Occurrence of Contrast-Induced Acute Kidney Injury and Long-Term Prognosis in Patients Undergoing Emergency Percutaneous Coronary Intervention |
title_sort |
association of serum lactate level with the occurrence of contrast-induced acute kidney injury and long-term prognosis in patients undergoing emergency percutaneous coronary intervention |
publisher |
Dove Medical Press |
series |
International Journal of General Medicine |
issn |
1178-7074 |
publishDate |
2021-07-01 |
description |
Gaoliang Yan, Dong Wang, Chengchun Tang, Genshan Ma Department of Cardiology, Zhongda Hospital of Southeast University Medical School, Nanjing, Jiangsu, People’s Republic of ChinaCorrespondence: Genshan MaDepartment of Cardiology, Zhongda Hospital of Southeast University Medical School, No. 87 Dingjiaqiao, Gulou District, Nanjing, Jiangsu, 210009, People’s Republic of ChinaTel/Fax +86 25 83262410Email Dr_magenshan@hotmail.comObjective: The association of lactate and contrast-induced acute kidney injury (CI-AKI) has not been well established. This prospective study was planned to identify the effects of lactate level on the occurrence of CI-AKI and long-term prognosis with acute myocardial infarction (AMI) patients undergoing emergency percutaneous coronary intervention (PCI).Methods: A total of 280 patients with AMI who underwent emergency PCI were selected from March 2018 to March 2019. A receiver operating characteristic (ROC) curve was used to analyze the optimal cut-off value of lactate on predicting CI-AKI after PCI. A multivariable logistic regression model was used to explore the significant predictors that might affect the occurrence of CI-AKI after univariate analysis. The primary endpoints were clinical outcomes including events: a combined endpoint of major adverse cardiovascular events, re-hospitalization due to heart failure, and worsening renal function. The Cox regression model was further used to analyze the predictors of the long-term prognosis after PCI.Results: Among the 280 patients, 64 patients (22.9%) developed CI-AKI after emergency PCI procedure. Multivariable logistic regression analysis revealed that baseline lactate level was the independent risk factor for the development of CI-AKI (OR, 3.657; 95% CI, 2.237– 5.978; p< 0.001). The area under the ROC curve for predicting CI-AKI of lactate was 0.786, and the optimum cut-off point of lactate was 3.02 mmol/L, with sensitivity of 65.6% and specificity of 85.2%. The incidence of primary endpoints in the high lactate group (lactate ≥ 3.02mmol/L) was significantly increased compared with the control group [26.3% (42/160) vs 15.8% (19/120), χ2=4.430, p=0.035]. Cox regression analysis also confirmed high lactate was an independent predictor for primary endpoint outcomes at 1-year follow-up (HR, 1.916; 95% CI, 1.118– 3.285; p=0.018).Conclusion: Our study demonstrates that baseline high lactate levels may be associated with an increased risk of CI-AKI and are the important predictors of long-term poor cardiorenal outcomes in AMI patients undergoing emergency PCI.Keywords: myocardial infarction, contrast media, acute kidney injury, lactate, percutaneous coronary intervention, prognosis |
topic |
myocardial infarction contrast media acute kidney injury lactate percutaneous coronary intervention prognosis |
url |
https://www.dovepress.com/the-association-of-serum-lactate-level-with-the-occurrence-of-contrast-peer-reviewed-fulltext-article-IJGM |
work_keys_str_mv |
AT yang theassociationofserumlactatelevelwiththeoccurrenceofcontrastinducedacutekidneyinjuryandlongtermprognosisinpatientsundergoingemergencypercutaneouscoronaryintervention AT wangd theassociationofserumlactatelevelwiththeoccurrenceofcontrastinducedacutekidneyinjuryandlongtermprognosisinpatientsundergoingemergencypercutaneouscoronaryintervention AT tangc theassociationofserumlactatelevelwiththeoccurrenceofcontrastinducedacutekidneyinjuryandlongtermprognosisinpatientsundergoingemergencypercutaneouscoronaryintervention AT mag theassociationofserumlactatelevelwiththeoccurrenceofcontrastinducedacutekidneyinjuryandlongtermprognosisinpatientsundergoingemergencypercutaneouscoronaryintervention AT yang associationofserumlactatelevelwiththeoccurrenceofcontrastinducedacutekidneyinjuryandlongtermprognosisinpatientsundergoingemergencypercutaneouscoronaryintervention AT wangd associationofserumlactatelevelwiththeoccurrenceofcontrastinducedacutekidneyinjuryandlongtermprognosisinpatientsundergoingemergencypercutaneouscoronaryintervention AT tangc associationofserumlactatelevelwiththeoccurrenceofcontrastinducedacutekidneyinjuryandlongtermprognosisinpatientsundergoingemergencypercutaneouscoronaryintervention AT mag associationofserumlactatelevelwiththeoccurrenceofcontrastinducedacutekidneyinjuryandlongtermprognosisinpatientsundergoingemergencypercutaneouscoronaryintervention |
_version_ |
1721319627639750656 |