Background There were few studies to explore the relationship between hemoglobin Alc （HbAlc）and contrast-induced acute renal injury （CI-AKI）in patients with type 2 diabetes mellitus （T2DM）. Methods Two hundred s...Background There were few studies to explore the relationship between hemoglobin Alc （HbAlc）and contrast-induced acute renal injury （CI-AKI）in patients with type 2 diabetes mellitus （T2DM）. Methods Two hundred seventy-nine patients with T2DM undergonging elective cardiac catheterization from Dongguan Kanghua Hospital were recruited. Patients were classified into quartiles based on HbAlc （ 〈 6.30%, 6.30- 6.70%, 6.71-7.70, and 〉 7.70%）. Baseline data, CI-AKI incidence and in-hospital outcomes were compared between the groups. Logistic regression was used to assess the relationship between HbAlc and CI-AKI. Results CI-AKI occurred in 26 （9.3%）patients. CI-AKI incidences of HbAlc quartiles were 4.6 %（3/65）, 2.8%（2/71）, 12.3%（9/73） and 17.1%（12/70） （P = 0.003）, respectively. There were no significant differences in in-hospital death or required renal replacement therapy among the four groups. Univariate logistic analysis showed that HbAlc was related with CI-AKI （OR = 1.319, 95%CI： 1.078-1.615, P = 0.007）. Multivariate analysis found that after adjusting eGFR 〈 60 ml/min/1.73 m2, age 〉 70 years and anemia, I-IbAlc 〉17% was still a significant independent risk factor for CI-AKI in patients with T2DM. Conclusions HbAlc is significantly associated with CI-AKI. HbAlc ≥ 7% may increase the risk of CI-AKI in patients with T2DM undergoing elective cardiac catheterization.展开更多
Background It was controversial that deferred stenting strategy could reduce no-reflow phenomena or major adverse cardiovascular events(MACEs)in primary percutaneous coronary intervention(PCI)for patients with STsegme...Background It was controversial that deferred stenting strategy could reduce no-reflow phenomena or major adverse cardiovascular events(MACEs)in primary percutaneous coronary intervention(PCI)for patients with STsegment elevation myocardial infarction(STEMI).Methods A total of 513 STEMI patients with high thrombus burden were retrospectively enrolled from January 2015 to January 2020.These patients were divided into two groups:experimental(with deferred stent implantation strategy,n=118)and control group(with immediate stenting strategy,n=395).The primary endpoint of this study was the incidence of no-reflow events.The secondly endpoints the in-hospital MACEs and one-year follow-up.Results The baseline characteristics were compared between the two groups.The occurrence of no-reflow phenomenon was significantly lower in the experiment group than the control group(16.9%vs.23.8%,P=0.035),which was mainly driven by the slow-flow(13.5%in experiment group vs.17.2%in control group,P=0.041).No significant difference was found between two groups in terms of in-hospital adverse events.The experiment group was associated with lower MACE rate than the control group(8.5%vs.15.7%,P=0.013)at one-year follow-up.Conclusions Deferred stenting had potential effect to reduce the risk no-reflow phenomenon in STEMI patients with high thrombus burden.This method was relatively safe and was associated with better clinical outcome.展开更多
文摘Background There were few studies to explore the relationship between hemoglobin Alc （HbAlc）and contrast-induced acute renal injury （CI-AKI）in patients with type 2 diabetes mellitus （T2DM）. Methods Two hundred seventy-nine patients with T2DM undergonging elective cardiac catheterization from Dongguan Kanghua Hospital were recruited. Patients were classified into quartiles based on HbAlc （ 〈 6.30%, 6.30- 6.70%, 6.71-7.70, and 〉 7.70%）. Baseline data, CI-AKI incidence and in-hospital outcomes were compared between the groups. Logistic regression was used to assess the relationship between HbAlc and CI-AKI. Results CI-AKI occurred in 26 （9.3%）patients. CI-AKI incidences of HbAlc quartiles were 4.6 %（3/65）, 2.8%（2/71）, 12.3%（9/73） and 17.1%（12/70） （P = 0.003）, respectively. There were no significant differences in in-hospital death or required renal replacement therapy among the four groups. Univariate logistic analysis showed that HbAlc was related with CI-AKI （OR = 1.319, 95%CI： 1.078-1.615, P = 0.007）. Multivariate analysis found that after adjusting eGFR 〈 60 ml/min/1.73 m2, age 〉 70 years and anemia, I-IbAlc 〉17% was still a significant independent risk factor for CI-AKI in patients with T2DM. Conclusions HbAlc is significantly associated with CI-AKI. HbAlc ≥ 7% may increase the risk of CI-AKI in patients with T2DM undergoing elective cardiac catheterization.
文摘Background It was controversial that deferred stenting strategy could reduce no-reflow phenomena or major adverse cardiovascular events(MACEs)in primary percutaneous coronary intervention(PCI)for patients with STsegment elevation myocardial infarction(STEMI).Methods A total of 513 STEMI patients with high thrombus burden were retrospectively enrolled from January 2015 to January 2020.These patients were divided into two groups:experimental(with deferred stent implantation strategy,n=118)and control group(with immediate stenting strategy,n=395).The primary endpoint of this study was the incidence of no-reflow events.The secondly endpoints the in-hospital MACEs and one-year follow-up.Results The baseline characteristics were compared between the two groups.The occurrence of no-reflow phenomenon was significantly lower in the experiment group than the control group(16.9%vs.23.8%,P=0.035),which was mainly driven by the slow-flow(13.5%in experiment group vs.17.2%in control group,P=0.041).No significant difference was found between two groups in terms of in-hospital adverse events.The experiment group was associated with lower MACE rate than the control group(8.5%vs.15.7%,P=0.013)at one-year follow-up.Conclusions Deferred stenting had potential effect to reduce the risk no-reflow phenomenon in STEMI patients with high thrombus burden.This method was relatively safe and was associated with better clinical outcome.
