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Zhu X, Zhang P, Xiong J, Wang N, Yang S, Zhu R, Zhang L, Liu W, Wu L. Effect of glomerular filtration rate in patients undergoing percutaneous coronary intervention: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31498. [PMID: 36343078 PMCID: PMC9646511 DOI: 10.1097/md.0000000000031498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Through meta-analysis of the relationship between glomerular filtration rate and major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI), we studied the impact of glomerular filtration rate on the prognosis of PCI. METHODS We collected literature on the incidence of MACE in patients with chronic kidney disease (CKD; estimated glomerular filtration rate < 60 mL/minute/1.73 m2) and patients with nonchronic kidney disease undergoing PCI. The search period was from January 1, 2000, to November 1, 2021. The searched databases included CNKI, Chinese Wanfang Data, China Biology Medicine disc, Web of Science, PubMed, and Cochrane Library. We used subgroup analysis and meta-regression to assess heterogeneity. RESULTS Twenty-one eligible studies were included, with 46,255 samples included, 4903 cases of MACE (10.6%), and patients with CKD had a higher risk of MACE after PCI (Risk ratios = 1.67; 95% confidence interval: 1.51-1.85). Multivariate meta regression results show that heterogeneity is related to region. The risk of MACEs in patients with CKD is different in different regions, and North America has the lowest risk, with an risk ratios value of 1.21 (95% confidence interval: 1.08-1.35). CONCLUSION Chronic kidney disease will increase the probability of MACE in patients with myocardial infarction after PCI and affect the prognosis of PCI. Therefore, clinical attention should be given to assessing glomerular filtration rate effects while treating patients with myocardial infarction with the PCI procedure.
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Affiliation(s)
- Xiang Zhu
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, People's Republic of China
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Sadre-Bafghi SA, Mohebi M, Hadi F, Parsaiyan H, Memarjafari M, Tayeb R, Ghodsi S, Sheikh-Sharbafan R, Poorhosseini H, Salarifar M, Alidoosti M, Haji-Zeinali AM, Amirzadegan A, Aghajani H, Jenab Y, Hosseini Z. Impact of Baseline Estimated Glomerular Filtration Rate Using CKD-EPI Equation on Long-term Prognosis of STEMI Patients: A Matter of Small Increments! Crit Pathw Cardiol 2022; 21:153-159. [PMID: 35994724 DOI: 10.1097/hpc.0000000000000296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Baseline biomarkers including glomerular filtration rate (GFR) guide the management of patients with ST-segment elevation myocardial infarction (STEMI). GFR is a tool for prediction of adverse outcomes in these patients. OBJECTIVES We aimed to determine the prognostic utility of estimated GFR using Chronic Kidney Disease Epidemiology Collaboration in a cohort of STEMI patients. METHODS A retrospective cohort was designed among 5953 patients with STEMI. Primary endpoint of the study was major adverse cardiovascular events. GFR was classified into 3 categories delineated as C1 (<60 mL/min), C2 (60-90), and C3 (≥ 90). RESULTS Mean age of the patients was 60.38 ± 5.54 years and men constituted 78.8% of the study participants. After a median of 22 months, Multivariate Cox-regression demonstrated that hazards of major averse cardiovascular event, all-cause mortality, cardiovascular mortality, and nonfatal myocardial infarction were significantly lower for subjects in C3 as compared with those in C1. Corresponding hazard ratios (HRs) for mentioned outcomes regarding C3 versus C1 were (95% confidence interval) were (HR = 0.852 [0.656-0.975]; P = 0.035), (HR = 0.425 [0.250-0.725]; P = 0.002), (HR = 0.425 [0.242-0.749]; P = 0.003), and (0.885 [0.742-0.949]; P = 0.003), respectively. Normal GFR was also associated with declined in-hospital mortality with HR of C3 versus C1: 0.299 (0.178-0.504; P < 0.0001). CONCLUSIONS Baseline GFR via Chronic Kidney Disease Epidemiology Collaboration is associated with long-term cardiovascular outcomes following STEMI.
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Affiliation(s)
- Seyed-Ali Sadre-Bafghi
- From the Afshar Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mehrnaz Mohebi
- Research Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hadi
- Department of Obstetrics and Gynecology, Imam Hossein Medical Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Parsaiyan
- Research Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Memarjafari
- Research Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Tayeb
- Research Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Ghodsi
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Sheikh-Sharbafan
- Research Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Poorhosseini
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Salarifar
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Alidoosti
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali-Mohammad Haji-Zeinali
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Amirzadegan
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Aghajani
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Jenab
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- Research Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Prognostic Value of Combining Apelin-12 and Estimated Glomerular Filtration Rate in Patients with ST-Segment Elevation Myocardial Infarction. J Interv Cardiol 2022; 2022:2272928. [PMID: 35847238 PMCID: PMC9249535 DOI: 10.1155/2022/2272928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background Apelin-12 and estimated glomerular filtration rate (eGFR) are considered prognostic factors for ST-segment elevation myocardial infarction (STEMI). However, little is known about whether the combined use of these two biomarkers could enhance the prognostic value. This study aimed to investigate the utility of combining apelin-12 and eGFR for STEMI. Methods Patients were divided into four groups based on median apelin-12 level and eGFR level: A: low apelin-12, low eGFR; B: low apelin-12, high eGFR; C: high apelin-12, low eGFR; and D: high apelin-12, high eGFR. The Cox regression was used to identify prognostic factors. The Kaplan–Meier and the receiver operating characteristic (ROC) curves were generated to evaluate the prognostic value of apelin-12 combined with eGFR in patients with STEMI. Results Among 460 patients, 118 (25.7%) experienced major adverse cardiac events (MACEs) during the entire follow-up of 30 months. The Kaplan–Meier curve analysis revealed that group D had the best prognosis compared with the other three groups. The combination of apelin-12 and eGFR (area under the ROC curve (AUC), 0.699) enhanced the predictive value for MACE compared with either apelin-12 (AUC, 0.617) or eGFR (AUC, 0.596) alone. There was a negative association between apelin-12 and eGFR (r = −0.32, p < 0.001), while no association was observed between the Gensini score and apelin-12 or eGFR. Conclusions This study suggests that both low apelin-12 (<0.76 ng/ml) and low eGFR (<94.06 mL/min/1.73 m2) are associated with poor prognosis in STEMI, indicating that the combination of apelin-12 and eGFR could enhance the prognostic value of patients with STEMI.
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Li G, Chi W, Bai B, Li Y, Wei T, Fu L. Dose-response associations between metabolic indexes and the risk of comorbid type 2 diabetes mellitus among rheumatoid arthritis patients from Northern China: a case-control study. BMJ Open 2019; 9:e028011. [PMID: 31278101 PMCID: PMC6615834 DOI: 10.1136/bmjopen-2018-028011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To investigate whether there were any differences in the patterns of metabolic abnormalities between patients with rheumatoid arthritis (RA) with comorbid type 2 diabetes mellitus (T2DM) and other populations, and to plot the dose-response relationships between metabolic indexes and the risk of comorbid T2DM among patients with RA. DESIGN AND SETTING This is a retrospective case-control study using electronic medical records (EMRs). Patients with RA and/or T2DM or controls who were admitted to the First Affiliated Hospital of China Medical University between April 2008 and December 2016 were retrospectively recruited through the EMR system. After age-matching and sex-matching, 261 controls, 274 patients with T2DM, 276 patients with RA and 151 patients with RA+T2DM were eventually recruited. RESULTS Patients with RA+T2DM exhibited higher levels of systolic blood pressure (SBP), fasting plasma glucose (FPG) and triglyceride (TG) than the RA only patients. Moreover, the proportions of impaired fasting glucose (IFG), and total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) dyslipidaemia in the RA+T2DM group were higher than those in the RA alone group (for IFG: 28.48% vs 18.84%, p=0.02; for TC: 25.17% vs 15.22%, p=0.01; for LDL-C: 25.83% vs 17.03%; p=0.03). Rheumatoid factor (RF) positivity and IFG were independent risk indicators for comorbid T2DM among patients with RA (for RF positivity: OR=0.45; 95% CI: 0.29 to 0.69; p<0.001; for IFG: OR=1.70; 95% CI: 1.04 to 2.76; p=0.03). CONCLUSION Linear dose-response associations between SBP, TC, TG and the risk of comorbid T2DM among patients with RA were observed, whereas a non-linear dose-response association between FPG and the risk of comorbid T2DM was found. Patients with RA+T2DM were more likely to exhibit metabolic abnormalities than RA only patients. Patients with RA+T2DM with metabolic abnormalities deserve more attention from rheumatologists and endocrinologists.
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Affiliation(s)
- Guangxiao Li
- Department of Medical Record Management Center, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Weijun Chi
- Department of Medical Record Management Center, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Bingqing Bai
- Department of Clinical Epidemiology and Evidence-Based Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ying Li
- Department of Experiment Teaching Center, School of Public Health, China Medical University, Shenyang, China
| | - Tingting Wei
- Department of Clinical Epidemiology and Evidence-Based Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Lingyu Fu
- Department of Medical Record Management Center, The First Affiliated Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology and Evidence-Based Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
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