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Impact of insulin resistance on contrast induced nephropathy in patients undergoing percutaneous coronary intervention

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Abstract

Contrast-induced nephropathy (CIN) is a common complication following percutaneous coronary intervention (PCI). Contrast-induced nephropathy after emergency PCI in subjects with insulin resistance (IR) has not been studied before. In this prospective study we determined the relation between IR on CIN, among those undergoing PCI due to acute coronary syndrome. One hundred twenty four consecutive acute coronary syndrome patients with diabetes (N = 44), insulin resistance (N = 38) and normal glycemic metabolism (N = 42) were included in the study. They were all treated with PCI. Pre- and post procedural creatinines were measured and independent predictors of CIN were analyzed. IR was defined as a HOMA level (HOMA-IR = Serum Glucose (mg/dL) X Plasma Insulin (micro unit/mL) / 405 >2.5. Patients with IR or diabetes had significantly higher levels of creatinine after procedure, serum cholesterol, glucose, contrast volume, hospital stay and HOMA. Female gender, frequency of CIN and multivessel disease were also higher in these patients. On the other hand they had significantly lower ejection fraction. Logistic regression analysis showed that HOMA was the single independent risk factor for CIN in patients with acute coronary syndrome treated with PCI. Insulin resistance is an independent risk factor for CIN in patients with acute coronary syndrome treated with PCI. It carries a similar risk with diabetes and proper prophylaxis should be performed.

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Conflict of interest

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Authors and Affiliations

  1. Department of Cardiology, Dicle University School of Medicine, 21280, Diyarbakır, Turkey

    Mehmet Ali Elbey, Mustafa Oylumlu, Mehmet Ata Akil, Mesut Aydın, Zihni Bilik, Abdurrahman Akyuz, Umit Inci & Fethullah Kayan

  2. Department of Biochemistry, Dicle University School of Medicine, Diyarbakır, Turkey

    Osman Evliyaoglu

  3. Department of Cardiology, Ataturk University School of Medicine, Erzurum, Turkey

    Ziya Simsek

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  1. Mehmet Ali Elbey
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  2. Osman Evliyaoglu
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  9. Umit Inci
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  10. Fethullah Kayan
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Correspondence to Mehmet Ali Elbey.

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Elbey, M.A., Evliyaoglu, O., Simsek, Z. et al. Impact of insulin resistance on contrast induced nephropathy in patients undergoing percutaneous coronary intervention. Int J Diabetes Dev Ctries 34, 40–44 (2014). https://doi.org/10.1007/s13410-013-0140-4

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  • DOI: https://doi.org/10.1007/s13410-013-0140-4

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