الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 146 |  |  |
| | | from | 146 | | |
Abstract
Acute Coronary Syndrome (ACS) is one of the leading causes of death worldwide. ACS refers to a wide spectrum of clinical presentations ranging for ST-segment elevation myocardial infarction (STEMI), non–ST-segment elevation myocardial infarction (NSTEMI) to unstable angina (UA). Contrast-induced nephropathy (CIN) is a serious complication of invasive cardiovascular procedures. The incidence of CIN is about 2% for the general population. However, patients undergoing percutaneous coronary intervention (PCI) are at higher risk. Several predictors for CIN after PCI, such as red cell distribution width, ACEF score (age, glomerular fraction, ejection fraction), Mehran score and CHA2DS2 VASC score have been assessed.. However, the role of SA & PLR in the development of CIN in patient with ACS undergoing interventional therapy is still debatable. This study aimed to assess Serum albumin level and platelet to lymphocytic ratio as predictors for Contrast – induced Nephropathy in Patients with Acute Coronary Syndromes treated with PCI procedures. This prospective cohort study was conducted on 100 patients diagnosed with ACS (STEMI, Non-STEMI, unstable angina) divided into two groups: • group 1: included 13 patients who had CIN. • group 2: included 87 patients who didn’t have CIN. All patients were subjected to full history taking, clinical examination, routine laboratory investigations, Twelve leads surface ECG, Transthoracic echocardiography, and percutaneous Coronary intervention. • Summary of our results: • Age was significantly higher in CIN group compared to non-CIN group and smoking was insignificantly different between both groups. • The incidence of DM and HTN, fluid need, diuretics, nephrotoxic drugs and previous CABG were significantly higher in CIN group compared to non-CIN group. • Type of ischemia and ischemic time were insignificantly different between both groups. • Serum albumin was significantly lower in CIN group compared to non-CIN group; PLR was significantly higher in CIN group compared to non-CIN group. Platelet count was insignificantly different between both groups. • Urea and creatinine were significantly different between before and after PCI in CIN group but were insignificantly different between before and after PCI in non-CIN group. By comparing between CIN and non-CIN groups, urea and creatinine were insignificantly different before PCI between both groups but was significantly higher after PCI in CIN group compared to non-CIN. • GFR was significantly lower after PCI compared to before in CIN group but was insignificantly different between before and after PCI in non-CIN group. By comparing between CIN and non-CIN groups, GFR was significantly lower before PCI in • CIN group compared to non-CIN and was significantly lower after PCI in CIN group compared to non-CIN. • EF was significantly lower in CIN compared to non-CIN groups. • TIMI grades were significantly different between before and after PCI in both groups, were significantly different after PCI in both groups and was insignificantly different before PCI in CIN and non-CIN groups. • Serum albumin can significantly predict development of CIN at AUC of 0.675 (P value= 0.015). At cut off > 3.7, serum albumin can predict development of CIN with sensitivity of 84.62%, specificity of 74.71, PPV of 33.3 and NPV of 97 • PLR can significantly predict development of CIN at AUC of 0.832 (P value<0.001). At cut off > 152, PLR can predict development of CIN with sensitivity of 92.31, specificity of 74.71, PPV of 35.3 and NPV of 98.5. PLR was significantly better predictor for development of CIN than serum albumin.