PDF(Pubmed)
Abstract：
UNASSIGNED: Cardiovascular disease (CVD) is the leading cause of mortality in kidney transplant (KT) patients. The perceived risk of contrast-induced nephropathy (CIN) may create a reluctance to perform coronary angiography in patients presenting with non-ST segment elevation myocardial infarction (NSTEMI).
UNASSIGNED: National Inpatient Sample (NIS) Database was used to sample individuals presenting with NSTEMI. Patients were stratified into KT and Non-KT cohorts. Outcomes included left heart catheterization rates, mortality, arrhythmias, acute kidney injury/acute renal failure (AKI/ARF), and extended length of hospital stay (ELOS) (>72 h). Propensity matching (1:1 ratio) and regression analyses were performed.
UNASSIGNED: Out of 336,354 patients with NSTEMI, 742 patients were in the KT group. KT patients were less likely to have LHC relative to non-KT patients (22.0 % vs 18.3 %); a difference that persisted on post-match analysis (27.1 % vs 19.4 %). On pre-match analysis, KT transplant patients that underwent LHC had lower mortality (10.3 % vs 0.7 %), AKI/ARF (44.6 % vs 27.9 %), arrhythmias (30.4 % vs 20.6 %) and lower ELOS (58.6 % vs 41.9 %). Post-match, KT cohort patient that underwent LHC had lower arrhythmias (OR:0.60[0.38-0.96]), AKI/ARF (OR = 0.51[0.34-0.77]), ELOS (OR:0.49[0.34-0.73]).
UNASSIGNED: KT patients underwent LHC much less frequently than their non-KT counterparts for NSTEMI. Coronary angiography and subsequent revascularization were associated with a significant decrease in morbidity and mortality. This theorized risk of CIN should not outweigh the benefit of LHC in KT patients.
UNASSIGNED: National Inpatient Sample (NIS) Database was used to sample individuals presenting with NSTEMI. Patients were stratified into KT and Non-KT cohorts. Outcomes included left heart catheterization rates, mortality, arrhythmias, acute kidney injury/acute renal failure (AKI/ARF), and extended length of hospital stay (ELOS) (>72 h). Propensity matching (1:1 ratio) and regression analyses were performed.
UNASSIGNED: Out of 336,354 patients with NSTEMI, 742 patients were in the KT group. KT patients were less likely to have LHC relative to non-KT patients (22.0 % vs 18.3 %); a difference that persisted on post-match analysis (27.1 % vs 19.4 %). On pre-match analysis, KT transplant patients that underwent LHC had lower mortality (10.3 % vs 0.7 %), AKI/ARF (44.6 % vs 27.9 %), arrhythmias (30.4 % vs 20.6 %) and lower ELOS (58.6 % vs 41.9 %). Post-match, KT cohort patient that underwent LHC had lower arrhythmias (OR:0.60[0.38-0.96]), AKI/ARF (OR = 0.51[0.34-0.77]), ELOS (OR:0.49[0.34-0.73]).
UNASSIGNED: KT patients underwent LHC much less frequently than their non-KT counterparts for NSTEMI. Coronary angiography and subsequent revascularization were associated with a significant decrease in morbidity and mortality. This theorized risk of CIN should not outweigh the benefit of LHC in KT patients.
摘要：
心血管疾病(CVD)是肾移植(KT)患者死亡的主要原因。在表现为非ST段抬高型心肌梗死（NSTEMI）的患者中，造影剂肾病（CIN）的感知风险可能导致不愿进行冠状动脉造影。
■国家住院患者样本(NIS)数据库用于对呈现NSTEMI的个体进行采样。将患者分为KT和非KT队列。结果包括左心导管插入率，死亡率,心律失常,急性肾损伤/急性肾功能衰竭（AKI/ARF），并延长住院时间（ELOS）（>72h）。进行倾向匹配(1:1比率)和回归分析。
■在336,354名NSTEMI患者中，KT组742例。相对于非KT患者，KT患者不太可能进行LHC（22.0％vs18.3％）；在匹配后分析中仍然存在差异（27.1％vs19.4％）。在赛前分析中，接受LHC的KT移植患者的死亡率较低（10.3％vs0.7％），AKI/ARF（44.6%对27.9%），心律失常（30.4％vs20.6％）和较低的ELOS（58.6％vs41.9％）。赛后,接受LHC的KT队列患者的心律失常较低（OR：0.60[0.38-0.96]），AKI/ARF（OR=0.51[0.34-0.77]），ELOS（或：0.49[0.34-0.73]）。
■KT患者接受LHC的频率远低于NSTEMI的非KT患者。冠状动脉造影和随后的血运重建与发病率和死亡率的显著降低相关。在KT患者中，CIN的这种理论风险不应超过LHC的益处。
■国家住院患者样本(NIS)数据库用于对呈现NSTEMI的个体进行采样。将患者分为KT和非KT队列。结果包括左心导管插入率，死亡率,心律失常,急性肾损伤/急性肾功能衰竭（AKI/ARF），并延长住院时间（ELOS）（>72h）。进行倾向匹配(1:1比率)和回归分析。
■在336,354名NSTEMI患者中，KT组742例。相对于非KT患者，KT患者不太可能进行LHC（22.0％vs18.3％）；在匹配后分析中仍然存在差异（27.1％vs19.4％）。在赛前分析中，接受LHC的KT移植患者的死亡率较低（10.3％vs0.7％），AKI/ARF（44.6%对27.9%），心律失常（30.4％vs20.6％）和较低的ELOS（58.6％vs41.9％）。赛后,接受LHC的KT队列患者的心律失常较低（OR：0.60[0.38-0.96]），AKI/ARF（OR=0.51[0.34-0.77]），ELOS（或：0.49[0.34-0.73]）。
■KT患者接受LHC的频率远低于NSTEMI的非KT患者。冠状动脉造影和随后的血运重建与发病率和死亡率的显著降低相关。在KT患者中，CIN的这种理论风险不应超过LHC的益处。
