Home Medicine Association of monocyte to HDL cholesterol level with contrast induced nephropathy in STEMI patients treated with primary PCI
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Association of monocyte to HDL cholesterol level with contrast induced nephropathy in STEMI patients treated with primary PCI

  • Saim Sağ EMAIL logo , Abdülmecit Yıldız , Aysel Aydin Kaderli , Bülent Cuma Gül , Ömer Bedir , Ercan Ceğilli , Bülent Özdemir , Fatma Ezgi Can and Ali Aydınlar
Published/Copyright: June 22, 2016
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 55 Issue 1

Abstract

Background:

Contrast induced nephropathy (CIN) has been proven to be a clinical condition related to adverse cardiovascular outcomes. In recent studies, the monocyte to high density lipoprotein ratio (MHR) has been postulated as a novel parameter associated with adverse renal and cardiovascular outcomes. In this study we investigated the association of MHR with CIN in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI).

Methods:

Consecutive STEMI patients treated with primary PCI were prospectively recruited. Subjects were categorized into two groups; as patients who developed CIN (CIN+) and patients who did not develop CIN (CIN–) during hospitalization. CIN was defined as either a 25% increase in serum creatinine from baseline or 44.20 µmol/L increase in absolute value, within 72 h of intravenous contrast administration.

Results:

A total number of 209 patients were included in the study. Thirty-two patients developed CIN (15.3%). In the CIN (+) patients, monocytes were higher [1.02 (0.83–1.39) vs. 0.69 (0.53–0.90) 109/L, p<0.01] and HDL cholesterol levels were lower [0.88 (0.78–1.01) vs. 0.98 (0.88–1.14) mmol/L, p<0.01]. In addition, MHR was significantly higher in the CIN (+) group [1.16 (0.89–2.16) vs. 0.72 (0.53–0.95) 109/mmol, p<0.01]. In multivariate logistic regression analysis, MHR, Mehran score, AGEF score and CV/eGFR were independently correlated with CIN.

Conclusions:

Higher MHR levels may predict CIN development after primary PCI in STEMI patients.

Keywords: contrast induced nephropathy; HDL-cholesterol; monocyte
Corresponding author: Dr. Saim Sağ, MD, Faculty of Medicine, Department of Cardiology, Uludag University Medical School, 16059, Bursa (Turkey), Phone: +90 224 2951640, Fax: +90 224 2951628

  1. Author contributions:All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership:None declared.

  4. Honorarium: None declared.

  5. Competing interests:The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Wichmann JL, Katzberg RW, Litwin SE, Zwerner PL, De Cecco CN, Vogl TJ, et al. Contrast-ınduced nephropathy. Circulation 2015;132:1931–6.10.1161/CIRCULATIONAHA.115.014672Search in Google Scholar PubMed

2. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002;39:930–6.10.1053/ajkd.2002.32766Search in Google Scholar PubMed

3. Marenzi G, Moltrasio M, Assanelli E, Lauri G, Marana I, Grazi M, et al. Impact of cardiac and renal dysfunction on inhospital morbidity and mortality of patients with acute myocardial infarction undergoing primary angioplasty. Am Heart J 2007;153:755–62.10.1016/j.ahj.2007.02.018Search in Google Scholar PubMed

4. Tziakas D, Chalikias G, Stakos D, Altun A, Sivri N, Yetkin E, et al. Validation of a new risk score to predict contrast-induced nephropathy after percutaneous coronary intervention. Am J Cardiol 2014;113:1487–93.10.1016/j.amjcard.2014.02.004Search in Google Scholar PubMed

5. Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, et al. Incidence and prognostic ımportance of acute renal failure after percutaneous coronary ıntervention. Circulation 2002;105:2259–64.10.1161/01.CIR.0000016043.87291.33Search in Google Scholar PubMed

6. Sudarsky D, Nikolsky E. Contrast-induced nephropathy in interventional cardiology. Int J Nephrol Renovasc Dis 2011;4:85–99.10.2147/IJNRD.S21393Search in Google Scholar PubMed PubMed Central

7. Maioli M, Toso A, Leoncini M, Micheletti C, Bellandi F. Effects of hydration in contrast-induced acute kidney injury after primary angioplasty: a randomized, controlled trial. Circ Cardiovasc Interv 2011;4:456–62.10.1161/CIRCINTERVENTIONS.111.961391Search in Google Scholar PubMed

8. Azzalini L, Spagnoli V, Ly HQ. Contrast-induced nephropathy: from pathophysiology to preventive strategies. Can J Cardiol 2016;32:247–55.10.1016/j.cjca.2015.05.013Search in Google Scholar PubMed

9. Ivanes F, Isorni MA, Halimi JM, Fauchier L, Saint Etienne C, Babuty D, et al. Predictive factors of contrast-induced nephropathy in patients undergoing primary coronary angioplasty. Arch Cardiovasc Dis 2014;107:424–32.10.1016/j.acvd.2014.05.008Search in Google Scholar PubMed

10. Geng Q, Ren J, Song J, Li S, Chen H. Meta-analysis of the effect of statins on renal function. Am J Cardiol 2014;114:562–70.10.1016/j.amjcard.2014.05.033Search in Google Scholar PubMed

11. Leoncini M, Toso A, Maioli M, Tropeano F, Villani S, Bellandi F. Early high-dose rosuvastatin for contrast-induced nephropathy prevention in acute coronary syndrome: results from the PRATO-ACS Study (Protective Effect of Rosuvastatin and Antiplatelet Therapy On contrast-induced acute kidney injury and myocardial damage in patients with Acute Coronary Syndrome). J Am Coll Cardiol 2014;63:71–9.10.1016/j.jacc.2013.04.105Search in Google Scholar PubMed

12. Li W, Fu X, Wang Y, Li X, Yang Z, Wang X, et al. Beneficial effects of high-dose atorvastatin pretreatment on renal function in patients with acute ST-segment elevation myocardial infarction undergoing emergency percutaneous coronary intervention. Cardiology 2012;122:195–202.10.1159/000339472Search in Google Scholar PubMed

13. McCullough PA, Adam A, Becker CR, Davidson C, Lameire N, Stacul F, et al. Risk prediction of contrast-induced nephropathy. Am J Cardiol 2006;98:27k–36k.10.1016/j.amjcard.2006.01.022Search in Google Scholar PubMed

14. Sahin I, Karabulut A, Avci II, Okuyan E, Biter HI, Yildiz SS, et al. Contribution of platelets indices in the development of contrast-induced nephropathy. Blood Coagul Fibrinolysis 2015;26:246–9.10.1097/MBC.0000000000000107Search in Google Scholar PubMed

15. Liu Y, Chen SQ, Duan CY, Tan N, Chen JY, Zhou YL, et al. Contrast volume-to-creatinine clearance ratio predicts the risk of contrast-ınduced nephropathy after percutaneous coronary ıntervention in patients with reduced ejection fraction. Angiology 2015;66:625–30.10.1177/0003319714548442Search in Google Scholar PubMed

16. Kurtul A, Yarlioglues M, Murat SN, Demircelik MB, Acikgoz SK, Ergun G, et al. Red cell distribution width predicts contrast-induced nephropathy in patients undergoing percutaneous coronary intervention for acute coronary syndrome. Angiology 2015;66:433–40.10.1177/0003319714535238Search in Google Scholar PubMed

17. Padhy M, Kaushik S, Girish MP, Mohapatra S, Shah S, Koner BC. Serum neutrophil gelatinase associated lipocalin (NGAL) and cystatin C as early predictors of contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention. Clin Chim Acta 2014;435:48–52.10.1016/j.cca.2014.04.016Search in Google Scholar PubMed

18. Karatas MB, Canga Y, Ozcan KS, Ipek G, Gungor B, Onuk T, et al. Monocyte to high-density lipoprotein ratio as a new prognostic marker in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am J Emerg Med 2016;34:240–4.10.1016/j.ajem.2015.10.049Search in Google Scholar PubMed

19. Cetin EH, Cetin MS, Canpolat U, Aydin S, Topaloglu S, Aras D, et al. Monocyte/HDL-cholesterol ratio predicts the definite stent thrombosis after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Biomark Med 2015;9:967–77.10.2217/bmm.15.74Search in Google Scholar PubMed

20. Canpolat U, Cetin EH, Cetin S, Aydin S, Akboga MK, Yayla C, et al. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic ınflammation. Clin Appl Thromb Hemost 2016;22:476–82.10.1177/1076029615594002Search in Google Scholar PubMed

21. Canpolat U, Aytemir K, Yorgun H, Sahiner L, Kaya EB, Cay S, et al. The role of preprocedural monocyte-to-high-density lipoprotein ratio in prediction of atrial fibrillation recurrence after cryoballoon-based catheter ablation. Europace 2015;17:1807–15.10.1093/europace/euu291Search in Google Scholar PubMed

22. Centers for Disease Control and Prevention (CDC). Cigarette smoking among adults – United States, 1992, and changes in the definition of current cigarette smoking. MMWR Morb Mortal Wkly Rep 1994;43:342.Search in Google Scholar

23. Laskey WK, Jenkins C, Selzer F, Marroquin OC, Wilensky RL, Glaser R, et al. Volume-to-creatinine clearance ratio: a pharmacokinetically based risk factor for prediction of early creatinine increase after percutaneous coronary intervention. J Am Coll Cardiol 2007;50:584–90.10.1016/j.jacc.2007.03.058Search in Google Scholar PubMed

24. Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol 2004;44:1393–9.10.1016/S0735-1097(04)01445-7Search in Google Scholar

25. Ando G, de Gregorio C, Morabito G, Trio O, Saporito F, Oreto G. Renal function-adjusted contrast volume redefines the baseline estimation of contrast-induced acute kidney injury risk in patients undergoing primary percutaneous coronary intervention. Circ Cardiovasc Interv 2014;7:465–72.10.1161/CIRCINTERVENTIONS.114.001545Search in Google Scholar PubMed

26. Ando G, Morabito G, de Gregorio C, Trio O, Saporito F, Oreto G. Age, glomerular filtration rate, ejection fraction, and the AGEF score predict contrast-induced nephropathy in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Catheter Cardiovasc Interv 2013;82:878–85.10.1002/ccd.25023Search in Google Scholar PubMed

27. Barrett BJ, Parfrey PS. Clinical practice. Preventing nephropathy induced by contrast medium. N Engl J Med 2006;354:379–86.10.1056/NEJMcp050801Search in Google Scholar PubMed

28. Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol 2011;58:e44–122.10.1016/j.jacc.2011.08.007Search in Google Scholar PubMed

29. Erdfelder E, Faul F, Buchner A. GPOWER: a general power analysis program. Behav Res Methods Instrum Comput 1996;28:1–11.10.3758/BF03203630Search in Google Scholar

30. Marenzi G, Cosentino N, Bartorelli AL. Acute kidney injury in patients with acute coronary syndromes. Heart 2015;101:1778–85.10.1136/heartjnl-2015-307773Search in Google Scholar PubMed

31. Marenzi G, Lauri G, Assanelli E, Campodonico J, De Metrio M, Marana I, et al. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol 2004;44:1780–5.10.1016/j.jacc.2004.07.043Search in Google Scholar PubMed

32. Bolognese L, Falsini G, Schwenke C, Grotti S, Limbruno U, Liistro F, et al. Impact of iso-osmolar versus low-osmolar contrast agents on contrast-induced nephropathy and tissue reperfusion in unselected patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (from the Contrast Media and Nephrotoxicity Following Primary Angioplasty for Acute Myocardial Infarction [CONTRAST-AMI] Trial). Am J Cardiol 2012;109:67–74.10.1016/j.amjcard.2011.08.006Search in Google Scholar PubMed

33. Marenzi G, Assanelli E, Marana I, Lauri G, Campodonico J, Grazi M, et al. N-acetylcysteine and contrast-induced nephropathy in primary angioplasty. N Engl J Med 2006;354:2773–82.10.1056/NEJMoa054209Search in Google Scholar PubMed

34. Stacul F, Adam A, Becker CR, Davidson C, Lameire N, McCullough PA, et al. Strategies to reduce the risk of contrast-induced nephropathy. Am J Cardiol 2006;98:59k–77k.10.1016/j.amjcard.2006.01.024Search in Google Scholar PubMed

35. Dai B, Liu Y, Fu L, Li Y, Zhang J, Mei C. Effect of theophylline on prevention of contrast-induced acute kidney injury: a meta-analysis of randomized controlled trials. Am J Kidney Dis 2012;60:360–70.10.1053/j.ajkd.2012.02.332Search in Google Scholar PubMed

36. Zagler A, Azadpour M, Mercado C, Hennekens CH. N-acetylcysteine and contrast-induced nephropathy: a meta-analysis of 13 randomized trials. Am Heart J 2006;151:140–5.10.1016/j.ahj.2005.01.055Search in Google Scholar PubMed

37. Wong PC, Li Z, Guo J, Zhang A. Pathophysiology of contrast-induced nephropathy. Int J Cardiol 2012;158:186–92.10.1016/j.ijcard.2011.06.115Search in Google Scholar PubMed

38. Ghattas A, Griffiths HR, Devitt A, Lip GY, Shantsila E. Monocytes in coronary artery disease and atherosclerosis: where are we now? J Am Coll Cardiol 2013;62:1541–51.10.1016/j.jacc.2013.07.043Search in Google Scholar PubMed

39. Krychtiuk KA, Kastl SP, Pfaffenberger S, Pongratz T, Hofbauer SL, Wonnerth A, et al. Small high-density lipoprotein is associated with monocyte subsets in stable coronary artery disease. Atherosclerosis 2014;237:589–96.10.1016/j.atherosclerosis.2014.10.015Search in Google Scholar PubMed PubMed Central

40. Rogacev KS, Zawada AM, Emrich I, Seiler S, Bohm M, Fliser D, et al. Lower Apo A-I and lower HDL-C levels are associated with higher intermediate CD14++CD16+ monocyte counts that predict cardiovascular events in chronic kidney disease. Arterioscler Thromb Vasc Biol 2014;34:2120–7.10.1161/ATVBAHA.114.304172Search in Google Scholar PubMed

41. Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol 2014;46:1619–25.10.1007/s11255-014-0730-1Search in Google Scholar PubMed

42. Murphy AJ, Dragoljevic D, Tall AR. Cholesterol efflux pathways regulate myelopoiesis: a potential link to altered macrophage function in atherosclerosis. Front Immunol 2014;5:490.10.3389/fimmu.2014.00490Search in Google Scholar PubMed PubMed Central

43. Murphy AJ, Woollard KJ, Hoang A, Mukhamedova N, Stirzaker RA, McCormick SP, et al. High-density lipoprotein reduces the human monocyte inflammatory response. Arterioscler Thromb Vasc Biol 2008;28:2071–7.10.1161/ATVBAHA.108.168690Search in Google Scholar PubMed

44. Tolani S, Pagler TA, Murphy AJ, Bochem AE, Abramowicz S, Welch C, et al. Hypercholesterolemia and reduced HDL-C promote hematopoietic stem cell proliferation and monocytosis: studies in mice and FH children. Atherosclerosis 2013;229:79–85.10.1016/j.atherosclerosis.2013.03.031Search in Google Scholar PubMed PubMed Central

Received: 2016-1-3
Accepted: 2016-5-18
Published Online: 2016-6-22
Published in Print: 2017-1-1

©2017 Walter de Gruyter GmbH, Berlin/Boston

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  26. Association of monocyte to HDL cholesterol level with contrast induced nephropathy in STEMI patients treated with primary PCI
  27. Low concentrations of adropin are associated with endothelial dysfunction as assessed by flow-mediated dilatation in patients with metabolic syndrome
  28. Preoperative serum potassium predicts the clinical outcome after non-cardiac surgery
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  32. Acknowledgment
  33. Letters to the Editor
  34. Normalisation issues in glucose measurements using phlebotomy tubes with liquid additives
  35. Utility of dilution tests in investigating interference in the free thyroxine assay
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https://doi.org/10.1515/cclm-2016-0005
Keywords for this article
contrast induced nephropathy; HDL-cholesterol; monocyte

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Describing children’s changes using clinical chemistry analytes
  4. Review
  5. Assessment of vitamin D status – a changing landscape
  6. Opinion Papers
  7. Order of blood draw: Opinion Paper by the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase (WG-PRE)
  8. The principles of Health Technology Assessment in laboratory medicine
  9. Genetics and Molecular Diagnostics
  10. Functional polymorphism of lncRNA MALAT1 contributes to pulmonary arterial hypertension susceptibility in Chinese people
  11. General Clinical Chemistry and Laboratory Medicine
  12. Influence of pneumatic tube system transport on routinely assessed and spectrophotometric cerebrospinal fluid parameters
  13. Estimation of hematocrit in filter paper dried bloodspots by potassium measurement: advantage of use of perimeter ring samples over circular center sub-punch samples
  14. Evaluation of the first fully automated immunoassay method for the measurement of stimulating TSH receptor autoantibodies in Graves’ disease
  15. Comparison of four immunoassays to measure serum ferritin concentrations and iron deficiency prevalence among non-pregnant Cambodian women and Congolese children
  16. Activity and expression of dipeptidyl peptidase IV on peripheral blood mononuclear cells in patients with early steroid and disease modifying antirheumatic drugs naïve rheumatoid arthritis
  17. Hematology and Coagulation
  18. Neutrophil CD64 Index as a superior biomarker for early diagnosis of infection in febrile patients in the hematology department
  19. Dilute Russell’s viper venom time reagents in lupus anticoagulant testing: a well-considered choice
  20. Reference Values and Biological Variations
  21. Pediatric reference intervals for alkaline phosphatase
  22. Cancer Diagnostics
  23. Transcript expression and genetic variability analysis of caspases in breast carcinomas suggests CASP9 as the most interesting target
  24. CDH1 (E-cadherin) expression independently affects clinical outcome in acute myeloid leukemia with normal cytogenetics
  25. Cardiovascular Diseases
  26. Association of monocyte to HDL cholesterol level with contrast induced nephropathy in STEMI patients treated with primary PCI
  27. Low concentrations of adropin are associated with endothelial dysfunction as assessed by flow-mediated dilatation in patients with metabolic syndrome
  28. Preoperative serum potassium predicts the clinical outcome after non-cardiac surgery
  29. Diabetes
  30. A simple colorimetric assay for measuring fructosamine 3 kinase activity
  31. Acknowledgment
  32. Acknowledgment
  33. Letters to the Editor
  34. Normalisation issues in glucose measurements using phlebotomy tubes with liquid additives
  35. Utility of dilution tests in investigating interference in the free thyroxine assay
  36. Plasminogen activator inhibitor-1 as a marker of cardiovascular response in professional mountain ultra-marathon runners
  37. Pitfalls of LSD screening assays: comparison of KIMS and CEDIA immunoassays with LC-MS
  38. A two site comparison of two point-of-care activated clotting time systems
  39. Detection of the common South-East Asian β0-thalassemia mutations in samples with borderline HbA2 levels
  40. Biclonal plasma cell myeloma with the simultaneous appearance of both secretory lambda and nonsecretory kappa monoclonal light chains
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