Predictive Value of Admission D-dimer for Contrast-induced Acute Kidney Injury and Poor Outcomes after Primary Percutaneous Coronary Intervention

• DOI: 10.21203/rs.2.17408/v1
• Publication Date: 2019-11-16T00:48:13Z
• Authors: Kai-Yang Lin; Han-Chuan Chen; Hui Jiang; Sun-Ying Wang; Hong-mei Chen; Zhi-Yong Wu; Feng Jiang; Yan-Song Guo; PENG-LI ZHU
• Keywords: Male; Contrast Media; Fibrin Fibrinogen Degradation Products; 03 medical and health sciences; Percutaneous Coronary Intervention; 0302 clinical medicine; Predictive Value of Tests; Risk Factors; Humans; Contrast-induced acute kidney injury; Prospective Studies; Outcome; Aged; Primary percutaneous coronary intervention; Acute Kidney Injury; Middle Aged; Diseases of the genitourinary system. Urology; Treatment Outcome; ROC Curve; D-dimer; Creatinine; ST Elevation Myocardial Infarction; Female; RC870-923; Research Article

Abstract DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI.Methods We prospectively enrolled 550 consecutive patients undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure.Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUC DD =0.729 vs AUC Mehran =0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95%CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005).Conclusion admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.