Clinical study on relationship between stress hyperglycemia and contrast-induced nephropathy in urgent coronary interventions

YANG Qing; ZHOU Yu-jie; ZHANG Jian-wei; YANG Shi-wei; NIE Bin

doi:10.3760/cma.j.issn.1673-4777.2013.06.006

Abstract：Objective To analyze the effect of stress hyperglycemia on the incidence of contrast-induced nephropathy (CIN) in patients undergoing urgent percutaneous coronary interventions without diabetes mellitus (DM).Methods All 318 patients undergoing urgent coronary interventions were enrolled from October 2008 to May 2011.All patients received low-osmolality nonionic contrast agent.Serum creatinine concentration (Cr) at baseline and each day for the following three days were measured.Based on the admission glucose levels,318 patients were divided into stress hyperglycemia group and non-stress hyperglycemia group.Univariate and Multivariate analysis were used to analyze the relationship between stress hyperglycemia and CIN.Results Among 318 patients,CIN occurred in 60 patients and the incidence of CIN was 18.9 ％.The stress hyperglycemia group had higher incidence of CIN than non-stress hyperglycemia group [28.6％ (18/63) vs 16.5％ (42/255),P ＜ 0.05].The white blood cell level,high sensitive C reactive protein and left ventricular ejection fraction showed significant differences between stress hyperglycemia group and non-stress hyperglycemia group [(10.4 ± 2.8) × 109/L vs (9.6 ±2.5) × 109/L,(9 ±5)mg/L vs (7 ±3)mg/L,(47 ±15)％ vs (51 ± 14)％,all P＜0.05].Reperfusion time in stress hyperglycemia group was longer than that in non-stress hyperglycemia group [(5.7 ± 1.8) h vs (4.5 ± 2.1) h,P ＜0.05].Multivariate analysis showed stress hyperglycemia was an independent risk factor of CIN (OR =1.59,95％ CI 1.32-1.86 ; P ＜ 0.05).Conclusion Stress hyperglycemia is an incidence risk factor of CIN in patients undergoing urgent percutaneous coronary interventions without DM.