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Relation of homocysteinemia to contrast-induced nephropathy in patients undergoing percutaneous coronary intervention.

 Seung Jun Kim  ;  Donghoon Choi  ;  Young-Guk Ko  ;  Jung-Sun Kim  ;  Seung Hyeok Han  ;  Byung-Keuk Kim  ;  Shin-Wook Kang  ;  Myeong-Ki Hong  ;  Yangsoo Jang  ;  Kyu Hun Choi  ;  Tae-Hyun Yoo 
 AMERICAN JOURNAL OF CARDIOLOGY, Vol.108(8) : 1086-1091, 2011 
Journal Title
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Aged ; Angioplasty, Balloon, Coronary* ; Contrast Media/adverse effects* ; Coronary Angiography/adverse effects ; Coronary Angiography/methods ; Female ; Follow-Up Studies ; Glomerular Filtration Rate/drug effects ; Homocysteine/blood* ; Humans ; Hyperhomocysteinemia/blood ; Hyperhomocysteinemia/chemically induced* ; Kidney Diseases/blood ; Kidney Diseases/chemically induced* ; Male ; Middle Aged ; Myocardial Infarction/blood ; Myocardial Infarction/diagnosis* ; Myocardial Infarction/therapy ; Prognosis ; Retrospective Studies ; Time Factors ; Triiodobenzoic Acids/adverse effects
Hyperhomocysteinemia induces oxidative stress and endothelial dysfunction, which share the proposed pathophysiologic mechanisms of contrast-induced nephropathy (CIN). However, no study has investigated the relation between hyperhomocysteinemia and CIN. The aim of the present study was to evaluate the effects of hyperhomocysteinemia on CIN in patients undergoing percutaneous coronary intervention. This was an observational cohort study that included 572 patients who underwent percutaneous coronary intervention. CIN was defined as an absolute ≥0.5 mg/dl or a relative ≥25% increase in the serum creatinine level at 48 hours after the procedure. The incidence of CIN was significantly greater in patients in the third homocysteine tertile (from lowest to highest, 4.7%, 7.3%, and 24.2%, p <0.001). Furthermore, the homocysteine levels were significantly greater in patients with CIN than in those without CIN (16.9 ± 4.9 vs 13.5 ± 4.2 μmol/L, p <0.001). In multiple logistic regression models, hyperhomocysteinemia was an independent risk factor for CIN (per the SD change in the plasma homocysteine level [4.44 μmol/L], odds ratio 1.70, 95% confidence interval 1.07 to 2.71, p = 0.025) after adjusting for major risk factors such as age, diabetes, and baseline cardiac and renal function. In subgroup analyses according to diabetes, acute coronary syndrome, or baseline estimated glomerular filtration rate, significant, graded associations were found between the homocysteine level and the incidence of CIN. In conclusion, hyperhomocysteinemia is independently associated with a greater risk of CIN in patients undergoing percutaneous coronary intervention.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Seung Jun(김승준)
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
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