Predictive Value of Monocyte to High-Density Lipoprotein Cholesterol Ratio for Contrast-Induced Nephropathy in Patients with ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention
Regayip Zehi̇r, Ahmet İlker Tekkeşi̇n, Nahide Haykır, Yalçın Veli̇bey, Edibe Betül Börklü, Ayça Gümüşdağ
Keywords: Contrast-induced nephropathy, primary percutaneous coronary intervention, ST segment elevation myocardial infarction, monocyte to high-density lipoprotein cholesterol ratio
Introduction: Contrast-induced nephropathy (CIN) is a serious complication in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (p-PCI). The monocyte to high-density lipoprotein (HDL) cholesterol ratio (MHR) has recently been defined as an inflammation and oxidative stress marker. The aim of this study was to evaluate the predictive value of MHR for risk of CIN in patients with ST who underwent p-PCI. Patients and Methods: Data of a 2120 patients who were hospitalised with the diagnosis of STEMI and underwent p-PCI were retrospectively evaluated. A relative increase in serum creatinine levels of ≥ 25% or an absolute increase of ≥ 0.5 mg/dL from the baseline within 72 h of contrast exposure was defined as CIN. MHR was calculated on emergency admission. The risk of CIN was evaluated across MHR values. Results: The incidence of CIN was 6.6% (n= 139). Age (p= 0.001), baseline creatinine levels (p< 0.001), DM (p< 0.001), HT (p< 0.001) and anaemia (p= 0.001) were higher in patients with CIN. The patients were divided into 2 groups based on the development of CIN. Peripheral monocyte count, HDL levels and MHR did not differ between the groups. After correction for all baseline confounders, neither peripheral monocyte count nor MHR were found to be independent predictors of CIN development in our multivariate logistic regression analyses. Conclusion: Because MHR does not differ much from that in stable patients at the early phase of infarction, it cannot be a potential predictor of CIN development in patients with STEMI who underwent p-PCI.