Informace o publikaci

Activation of the Nitric Oxide Pathway and Acute Myocardial Infarction Complicated by Acute Kidney Injury

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PAŘENICA Jiří KALA Petr MEBAZAA Alexandre LITTNEROVÁ Simona BENEŠOVÁ Klára TOMANDL Josef PÁVKOVÁ GOLDBERGOVÁ Monika JARKOVSKÝ Jiří ŠPINAR Jindřich TOMANDLOVÁ Marie DASTYCH Milan INCE Can HELÁNOVÁ Kateřina TESÁK Martin HELÁN Martin LOKAJ Petr LEGRAND Matthieu

Rok publikování 2020
Druh Článek v odborném periodiku
Časopis / Zdroj CARDIORENAL MEDICINE
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://www.karger.com/Article/FullText/503718
Doi http://dx.doi.org/10.1159/000503718
Klíčová slova Acute kidney injury; Nitric oxide; Myocardial infarction; Oxidative stress; Cardio renal
Popis Background/Aims: The pathophysiology of acute kidney injury (AKI) in ST-elevation myocardial infarction (STEMI) patients remains poorly explored. The involvement of the nitric oxide (NO) pathway has been demonstrated in experimental ischemic AKI. The aim of this study was to assess the predictive value of circulating biomarkers of the NO pathway for AKI in STEMI patients. Methods: Four hundred and twenty-seven STEMI patients treated with primary percutaneous coronary intervention were included. The primary end point was AKI. Biomarkers of the NO pathway (plasma superoxide dismutase [SOD], uric acid, nitrite/nitrate [NOx], neopterin) as well as cardiac biomarkers (B-type natriuretic peptide [BNP] and troponin) were sampled 12 h after admission. The predictive value of circulating biomarkers was evaluated in addition to the multivariate clinical model. Results: AKI developed in 8.9% of patients. The 3-month mortality was significantly higher in patients with AKI (34.2 vs. 4.1%; p < 0.001). SOD, uric acid, NOx, neopterin, BNP and troponin were significantly associated with the development of AKI (area under curve [AUC]-receiver operating curve [ROC] ranging between 0.70 and 0.81). In multivariate analysis cardiogenic shock, neopterin, NOx and troponin were independent predictors of AKI. AUC-ROC of the association of multibiomarkers and clinical model was 0.90 and outperformed the predictive value of the clinical model alone. OR of NOx >= 45 mu mol/L was 8.0 (95% CI 3.1-20.6) for AKI. Conclusion: Biomarkers of the NO pathway are associated with the development of AKI in STEMI patients. These results provide insights into the pathophysiology of AKI and may serve at developing preventing strategies for AKI targeting this pathway.
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