Association of Serum Bilirubin with Contrast-Induced Nephropathy and Future Cardiovascular Events in Patients Undergoing Coronary Intervention 英文参考文献.docVIP

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Association of Serum Bilirubin with Contrast-Induced Nephropathy and Future Cardiovascular Events in Patients Undergoing Coronary Intervention 英文参考文献.doc

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Association of Serum Bilirubin with Contrast-Induced Nephropathy and Future Cardiovascular Events in Patients Undergoing Coronary Intervention 英文参考文献

AssociationofSerumBilirubinwithContrast-Induced NephropathyandFutureCardiovascularEventsin PatientsUndergoingCoronaryIntervention Shao-SungHuang1,3,Po-HsunHuang1,3,4*,Tao-ChengWu1,3,4,Jaw-WenChen1,2,4,5,Shing-JongLin1,2,3,4 1Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, 2Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan,3InstituteofClinicalMedicine,NationalYang-MingUniversity,Taipei,Taiwan,4CardiovascularResearchCenter,NationalYang-MingUniversity,Taipei,Taiwan, 5InstituteandDepartmentofPharmacology,NationalYang-MingUniversity,Taipei,Taiwan Abstract Objectives:Enhancedreactiveoxygenspeciesformationwithinthekidneyfollowingtheadministrationofcontrastmedia may play a key role in the development of contrast-induced nephropathy (CIN). Bilirubin has emerged as an important endogenousantioxidantmolecule.ThisstudywasundertakentodeterminewhetherbilirubinisassociatedwithCINand futurecardiovasculareventsinpatientsundergoingcoronaryintervention. Methods:Totally,544consecutivepatientsreceivedcoronaryinterventionwereenrolled.Allpatientswerefollowedupfor atleast3yearsoruntiltheoccurrenceofamajorevent.TheprimaryendpointwasCIN,definedasariseinserumcreatinine (SCr)of0.5mg/dlora25%increasefromthebaselinevaluewithin48hoursaftertheprocedure.Thesecondaryendpoint was the combined occurrence of major adverse cardiovascular events (MACE), including death, nonfatal myocardial infarction,andischemicstroke. Results:Overall,CINoccurredin85(15.6%)patients.Allpatientswerestratifiedinto3groups(low/normal/high)according totheserumbilirubinlevels.Inamultivariatelogisticanalysis,theoddsratioforCINwithlow-bilirubin levelsrelativeto high-bilirubinlevelswas11.82(95%CI,3.25–43.03).ByCoxregressionanalysis,serumbilirubinlevelswasanindependent predictorofMACEinpatientsundergoingcoronaryintervention(lowvs.highhazardratio2.26;95%CI,1.05–4.90). Conclusions:CINisaseriouscomplicationofcoronaryintervention.Higherserumbilirubinconce