Abstract: SA-PO033

Antithrombin III Is a Novel Predictor for Contrast Induced Nephropathy after Coronary Angiography: An Observational, Cross-Sectional Study

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Yin, Jianyong, Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
  • Wang, Feng, Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
  • Wang, Niansong, Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
Background

Antithrombin III (AT-III) functions as an important endogenous anticoagulant and has powerful anti-inflammatory effects. Low AT-III activity is considered to be a predictor of poor outcomes in several conditions, including acute kidney injury after cardiac surgery. However, whether the AT-III levels are related to the incidence of contrast induced nephropathy(CIN) has not been identified yet.

Methods

A cross-sectional study on CIN after CAG was conducted to identify the potential predictive value of AT-III for CIN. A total of 460 patients who underwent coronary angiography(CAG) from January 2015 to December 2016 in coronary care units(CCU) were enrolled. CIN was diagnosed according to the KDIGO guideline. Plasma AT-III activity was measured before CAG and <75% was recognized as low activity according to reference values.

Results

Of 460 patients undergoing CAG, 125(27.17%) developed CIN. The incidence of CIN was significantly higher in patients with low AT-III activities than that in normal group (Pearson’s chi-squared test P=0.002). Besides, with the decline of AT-III activity, the prevalence of CIN progressively rise, with the highest value(58.8%) in patients with AT-III activity<60%. Moreover, the AT-III activity was significantly lower in CIN patients than that in non-CIN ones(84.43±16.3% vs. 92.14±13.94%,P<0.001). After multivariable analysis, low AT-III activity remained a significant independent predictor of CIN(OR 2.207,95%CI[1.29-3.777];P=0.004) as well as baseline serum creatinine(OR 1.009,95%CI[1.001-1.016];P=0.026).

Conclusion

Patients with low AT-III activities presented a higher risk of developing CIN after CAG. And the initial AT-III activity may be an independent predictor for CIN.

Funding

  • Government Support - Non-U.S.