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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2018 ; 13
(3
): e0194152
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Growth differentiation factor-15 levels and the risk of contrast induced acute
kidney injury in acute myocardial infarction patients treated invasively: A
propensity-score match analysis
#MMPMID29529072
Sun L
; Zhou X
; Jiang J
; Zang X
; Chen X
; Li H
; Cao H
; Wang Q
PLoS One
2018[]; 13
(3
): e0194152
PMID29529072
show ga
BACKGROUND: Growth differentiation factor-15 (GDF-15) is an emerging biomarker
for risk stratification in cardiovascular disease. Contrast-induced acute kidney
injury (AKI) is an important complication in patients undergoing coronary
angiography (CAG) or percutaneous coronary intervention (PCI). In this
retrospectively observational study, we aimed to determine the role of GDF-15 and
the risk of AKI in acute myocardial infarction (AMI) patients. METHODS: The
medical records of 1195 patients with AMI were reviewed. After exclusion
criteria, a total of 751 eligible patients who underwent CAG or PCI were studied.
Preoperative clinical parameters including GDF-15 levels were recorded.
Multivariate logistic regression analysis was used to identify the risk factors
of AKI. Subsequently, to reduce a potential selection bias and to balance
differences between the two groups, a propensity score-matched analysis was
performed. We recorded the 30-day all-cause mortality of the total study
population. Kaplan-Meier analysis was performed to identify the association
between short term survival in AMI patients and GDF-15 level. RESULTS: Among 751
enrolled patients, 106 patients (14.1%) developed AKI. Patients were divided into
two groups: AKI group (n = 106) and non-AKI group (n = 645). GDF-15 levels were
significantly higher in AKI group compared to non-AKI group (1328.2 ± 349.7 ng/L
vs. 1113.0 ± 371.3 ng/L, P <0.001). Multivariate logistic regression analyses
showed GDF-15 was an independent risk factor of AKI (per 1000 ng/L increase of
GDF-15, OR: 3.740, 95% CI: 1.940-7.207, P < 0.001). According to GDF-15 tertiles,
patients were divided into three groups. Patients in middle (OR 2.93, 95% CI:
1.46-5.89, P = 0.003) and highest GDF-15 tertile (OR 3.72, 95% CI: 1.87-7.39, P
<0.001) had higher risk of AKI compared to patients in the lowest GDF-15 tertile.
The propensity score-matched group set comprised of 212 patients. Multivariate
logistic regression revealed that GDF-15 is still an independent risk factor for
AKI after matching (per 1000 ng/L increase of GDF-15, OR: 2.395, 95% CI:
1.020-5.626, P = 0.045). Based on the Kaplan-Meier analysis, the risk of 30-day
all-cause mortality increased in higher GDF-15 tertiles log rank chi-square:
29.895, P <0.001). CONCLUSION: This suggests that preoperative plasma GDF-15 is
an independent risk factor of AKI in AMI patients underwent CAG or PCI. GDF-15
and AKI are associated with poor short term survival of AMI patients.