The predictive value of urinary ATF-3 on contrast-induced nephropathy in elderly patients after percutaneous coronary intervention
Objective To study the predictive value of activating transcription factor 3(ATF-3)on contrast-induced nephropathy(CIN)in elderly patients after percutaneous coronary intervention(PCI).Methods There were 300 elderly patients with coronary atherosclerotic heart disease undergoing elective PCI were selected.All patients were divided into CIN group(n=21)and non CIN group(n=279)according to whether they had CIN or not.The clinical data of the two groups were compared,including gender,age,heart rate,comorbidities,bad habits,blood routine,biochemical index,urine routine and history of taking drugs.The renal function indexes(preoperative serum creatinine,preoperative glomerular filtration rate(GFR),and urinary ATF-3 preoperatively,at 2,8,12 and 24 h postoperatively)were compared at different time intervals,and the receiver operating characteristic(ROC)curves of the subjects were plotted to calculate the areas under the curves(AUC),and to analyze the early predictive value of the urinary ATF-3 level at different time intervals for CIN.Results In the CIN group,the age was(80.57±3.64)years,14 cases(66.67%)had diabetes mellitus,the uric acid was(308.00±42.74)μmol/L,13 cases(61.90%)took aspirin enteric-coated tablets;in the non-CIN group,the age was(74.84±6.69)years,119 cases(42.65%)had diabetes mellitus,the uric acid was(334.35±49.51)μmol/L,111 cases(39.78%)took aspirin enteric-coated tablets.Comparison of age,percentage of diabetes mellitus,uric acid,and percentage of taking aspirin enteric-coated tablets between the two groups showed a statistically significant difference(P<0.05).Comparison of gender,heart rate,percentage of hypertension,percentage of smoking,white blood cell count,red blood cell count,hemoglobin,platelet count,total cholesterol,triglyceride,low density lipoprotein cholesterol,high density lipoprotein cholesterol,and the percentage of taking statin,angiotensin-converting enzyme inhibitor(ACEI)/angiotensin receptor antagonist(ARB),β-blocker,and calcium channel antagonist between the two groups showed no statistically significant difference(P>0.05).Comparison of preoperative serum creatinine,preoperative GFR and preoperative urinary ATF-3 between the two groups showed no statistically significant difference(P>0.05).Urinary ATF-3 levels in CIN group were(0.65±0.18),(1.27±0.12),(0.97±0.15)and(0.74±0.15)ng/ml at 2,8,12 and 24 h postoperatively,which were higher than(0.55±0.18),(1.04±0.19),(0.74±0.20)and(0.58±0.17)ng/ml in the non-CIN group,and the differences were statistically significant(P<0.05).In this study,the ROC curves of urinary ATF-3 at different time intervals revealed that the AUC of urinary ATF-3 at 2 h postoperatively was 0.660,the detection cutoff was 0.660,the sensitivity was 0.667,and the specificity was 0.638;the AUC of urinary ATF-3 at 8 h postoperatively was 0.851,the optimal cutoff point was 1.105,the sensitivity was 0.952,and the specificity was 0.634;the AUC of urinary ATF-3 at 12 h postoperatively was 0.816,the optimal cutoff point was 0.800,the sensitivity was 0.905,and the specificity was 0.631;the AUC of urinary ATF-3 at 24 h postoperatively was 0.752,the optimal cutoff point was 0.635,the sensitivity was 0.812,and the specificity was 0.656.Compared with 2,12,and 24 h postoperatively,the detection of urinary ATF-3 at 8 h postoperatively was of high clinical significance for the early diagnosis of CIN.Conclusion The detection of urinary ATF-3 has a certain value in the early prediction of CIN in elderly patients after PCI.
Urinary activating transcription factor 3Percutaneous coronary interventionContrast-induced nephropathyPredictive value
万方数据
维普
