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Glycemic variability as predictor of contrast-induced nephropathy in diabetic patients with acute myocardial infarction undergoing percutaneous coronary intervention

BACKGROUND: Contrast-induced nephropathy (CIN) is a frequent complication in patients undergoing percutaneous coronary intervention (PCI). Diabetes mellitus (DM) and acute myocardial infarction (AMI) are associated with an increased risk of CIN. However, it remains unclear whether glycemic variabili...

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Autores principales: Zuo, Pengfei, Li, Yongjun, Zuo, Zhi, Wang, Xin, Ma, Genshan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729303/
https://www.ncbi.nlm.nih.gov/pubmed/33313250
http://dx.doi.org/10.21037/atm-20-6968
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author Zuo, Pengfei
Li, Yongjun
Zuo, Zhi
Wang, Xin
Ma, Genshan
author_facet Zuo, Pengfei
Li, Yongjun
Zuo, Zhi
Wang, Xin
Ma, Genshan
author_sort Zuo, Pengfei
collection PubMed
description BACKGROUND: Contrast-induced nephropathy (CIN) is a frequent complication in patients undergoing percutaneous coronary intervention (PCI). Diabetes mellitus (DM) and acute myocardial infarction (AMI) are associated with an increased risk of CIN. However, it remains unclear whether glycemic variability (GV) has the important prognostic significance of CIN in diabetic patients with AMI undergoing PCI. We conducted this study to investigate the independent prognostic value of the in-hospital GV in diabetic patients who presented with AMI and were treated with PCI. METHODS: The study group comprised 252 diabetic patients with AMI who underwent PCI and were assigned to CINand non-CIN groups. A continuous glucose monitoring system (CGMS) was used to determine the mean amplitude of glycemic excursion (MAGE), a representative index of GV. Independent risk factors for CIN were determined by multivariate logistic regression analysis (MLRA), and receiver-operating characteristic (ROC) analysis was used to measure the prognostic potential of GV. RESULTS: A total of 55 patients had CIN and they showed markedly elevated MAGE compared with the non-CIN group. MLRA revealed that MAGE had potential to independently predict CIN. The area under the ROC curve, optimal cut-point value, sensitivity and specificity for MAGE were 0.739, 2.95, 70.91% and 61.42%, respectively. CONCLUSIONS: In diabetic AMI patients undergoing PCI, high GV is associated with increased risk of CIN.
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spelling pubmed-77293032020-12-11 Glycemic variability as predictor of contrast-induced nephropathy in diabetic patients with acute myocardial infarction undergoing percutaneous coronary intervention Zuo, Pengfei Li, Yongjun Zuo, Zhi Wang, Xin Ma, Genshan Ann Transl Med Original Article BACKGROUND: Contrast-induced nephropathy (CIN) is a frequent complication in patients undergoing percutaneous coronary intervention (PCI). Diabetes mellitus (DM) and acute myocardial infarction (AMI) are associated with an increased risk of CIN. However, it remains unclear whether glycemic variability (GV) has the important prognostic significance of CIN in diabetic patients with AMI undergoing PCI. We conducted this study to investigate the independent prognostic value of the in-hospital GV in diabetic patients who presented with AMI and were treated with PCI. METHODS: The study group comprised 252 diabetic patients with AMI who underwent PCI and were assigned to CINand non-CIN groups. A continuous glucose monitoring system (CGMS) was used to determine the mean amplitude of glycemic excursion (MAGE), a representative index of GV. Independent risk factors for CIN were determined by multivariate logistic regression analysis (MLRA), and receiver-operating characteristic (ROC) analysis was used to measure the prognostic potential of GV. RESULTS: A total of 55 patients had CIN and they showed markedly elevated MAGE compared with the non-CIN group. MLRA revealed that MAGE had potential to independently predict CIN. The area under the ROC curve, optimal cut-point value, sensitivity and specificity for MAGE were 0.739, 2.95, 70.91% and 61.42%, respectively. CONCLUSIONS: In diabetic AMI patients undergoing PCI, high GV is associated with increased risk of CIN. AME Publishing Company 2020-11 /pmc/articles/PMC7729303/ /pubmed/33313250 http://dx.doi.org/10.21037/atm-20-6968 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Zuo, Pengfei
Li, Yongjun
Zuo, Zhi
Wang, Xin
Ma, Genshan
Glycemic variability as predictor of contrast-induced nephropathy in diabetic patients with acute myocardial infarction undergoing percutaneous coronary intervention
title Glycemic variability as predictor of contrast-induced nephropathy in diabetic patients with acute myocardial infarction undergoing percutaneous coronary intervention
title_full Glycemic variability as predictor of contrast-induced nephropathy in diabetic patients with acute myocardial infarction undergoing percutaneous coronary intervention
title_fullStr Glycemic variability as predictor of contrast-induced nephropathy in diabetic patients with acute myocardial infarction undergoing percutaneous coronary intervention
title_full_unstemmed Glycemic variability as predictor of contrast-induced nephropathy in diabetic patients with acute myocardial infarction undergoing percutaneous coronary intervention
title_short Glycemic variability as predictor of contrast-induced nephropathy in diabetic patients with acute myocardial infarction undergoing percutaneous coronary intervention
title_sort glycemic variability as predictor of contrast-induced nephropathy in diabetic patients with acute myocardial infarction undergoing percutaneous coronary intervention
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729303/
https://www.ncbi.nlm.nih.gov/pubmed/33313250
http://dx.doi.org/10.21037/atm-20-6968
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