Association between Pan-Immune-Inflammation Value and Contrast-Induced Nephropathy with Coronary Angiography.

Background: Contrast-induced nephropathy (CIN) is one of the most important complications after invasive cardiovascular procedures. Considering the pivotal role of inflammation in CIN development, the use of peripheral blood-based indexes may be an easily available biomarker to predict CIN risk. Therefore, in the present study, we evaluated the association between the pan-immune-inflammation value (PIV) and the risk of CIN. Patients and Methods: A total of 1343 patients undergoing coronary angiography (CAG) were included. The PIV was calculated with the following equation: (neutrophil count × platelet count × monocyte count)/lymphocyte count. Multivariable regression analyses were used to determine the association between clinical and laboratory parameters and CIN development. Results: The median age of the cohort was 58 (IQR 50-67), and 48.2% of the patients were female. CIN developed in 202 patients (15%) in follow-up. In multivariate analyses, older age (OR: 1.015, 95% CI: 1.002-1.028, p = 0.020) and higher PIV levels (OR: 1.016, 95% CI: 1.004-1.028, p = 0.008) were associated with a higher CIN risk, while the use of antiplatelet agents was associated with a lower risk of CIN (OR: 0.670, 95% CI: 0.475-0.945, p = 0.022). Conclusions: We demonstrated that the risk of CIN was significantly higher in patients with higher PIV and older patients in a large cohort of patients undergoing CAG for stable ischemic heart disease. If supported with prospective evidence, PIV levels could be used as a minimally invasive reflector of CIN.

Changes in Cardiac Structure and Function of Recipients after Kidney Transplantation.

Background: Chronic kidney disease (CKD) elevates the risk of cardiovascular disease (CVD) and mortality. Uremic cardiomyopathy, frequently observed in CKD and end-stage renal disease (ESRD), involves alterations in cardiac structure and function, which may reverse post-kidney transplantation, although data remain controversial. This study examines the relationship between graft function and changes in cardiac parameters pre- and post-transplantation in kidney transplant recipients. Methods: A total of 145 pediatric and adult recipients of living or deceased donor kidney transplants were enrolled at Gazi Yasargil Training and Research Hospital. This cohort study utilized transthoracic echocardiographic (TTE) imaging pre-transplant and at least two years post-transplant. Echocardiographic parameters were analyzed using standard techniques. Results: The mean age of the participants was 35 years, with 60% male. The average dialysis duration prior to transplantation was 27 months. Most recipients (83.4%) received kidneys from living donors. Left ventricular diastolic dysfunction increased significantly post-transplant (p < 0.05), while other cardiac dimensions and functions, such as ejection fraction and pulmonary artery pressure, showed no significant change (p > 0.05). Notably, diastolic dysfunction worsened in patients with dysfunctional grafts (GFR < 45), correlating with increased pulmonary artery pressure post-transplant. The rate of antihypertensive drug use and the prevalence of diabetes mellitus increased significantly post-transplant (p < 0.05). Conclusions: This study demonstrates that left ventricular diastolic dysfunction present before kidney transplantation continues to persist post-transplantation in patients with end-stage renal disease undergoing chronic kidney disease treatment. Furthermore, it shows an increased rate of pulmonary artery pressure and pericardial effusion in patients with dysfunctional grafts after transplantation. Further research is required to explore strategies to reverse uremic cardiomyopathy and reduce cardiovascular risk in these patients.

Association between C-Reactive Protein to Albumin Ratio and Multi-Vessel Coronary Artery Disease in Patients with Stable Coronary Artery Disease.

Multivessel coronary artery disease (MV-CAD) remains a prevalent and serious health concern despite advances in treatment. Early identification and risk stratification are crucial for optimizing treatment. The CRP-to-albumin ratio (CAR) has emerged as a promising biomarker in various inflammatory diseases. This study investigated the potential of CAR as a marker for MV-CAD. We retrospectively analyzed 1360 patients with suspected CAD. Patients were divided into three groups based on CAR tertiles. Logistic regression analyses were carried out to estimate the association between MHR and MV-CAD. Elevated CAR levels were significantly associated with an increased prevalence of CAD (p < 0.001), severe CAD (p < 0.001), and MV-CAD (p < 0.001). Patients with the highest CAR tertile had five times higher odds of MV-CAD compared to the lowest tertile (p < 0.001). CAR demonstrated moderate accuracy in predicting MV-CAD (AUC: 0.644, 95% CI: 0.615-0.674, p < 0.001). CAR holds promise as a tool for the early identification and risk stratification of multivessel CAD. Further research is warranted to validate its clinical utility and explore its potential to guide treatment decisions and improve outcomes in patients with this high-risk condition.

Association between pan-immune-inflammation value and coronary slow flow phenomenon in patients with angiographically normal coronary arteries.

INTRODUCTION: Coronary slow flow phenomenon (CSFP) is characterized by the delayed contrast filling of terminal vessels of coronary arteries in the presence of normal or nearly normal epicardial coronary arteries. Given that inflammation plays a role in cardiovascular disorders, including CSFP, using peripheral blood-derived compound prognostic indexes could be a feasible way to predict the presence of CSFP. Therefore, in the present study, we evaluated the association between pan-immune-inflammation value (PIV) and the CSFP. METHODS: This single-center, retrospective study was composed of 612 patients aged over 18 years who underwent CAG for suspected stable ischemic heart disease. The association of clinical and laboratory parameters with the CSFP was evaluated with univariate and multivariate analyses. RESULTS: The median age of the patients was 54 (IQR 46-63) and 61.3% of the patients were male. The 12.6% (84/612) of the patients had CSFP, while the coronary flow was normal in the remaining 87.4% of patients. The PIV levels had moderate success for the prediction of the CSFP (AUC: 0.675, 95% CI: 0.615-0.735, p < 0.001). In multivariate analyses, male gender (OR: 4.858, 95% CI: 2.851-8.277, p < 0.001), presence of diabetes (OR: 2.672, 95% CI: 1.396-5.113, p = 0.003), lower HDL-C values (OR: 2.120, 95% CI: 1.286-3.496, p = 0.003), and higher PIV levels (OR: 2.527, 95% CI: 1.519-4.203, p < 0.001) were associated with a higher risk of CSFP. CONCLUSION: We demonstrated that a higher risk of CSFP in patients with PIV levels. If supported by prospective evidence, PIV levels could be used as a minimally invasive reflector of CSFP.

Effects of acute kidney injury on clinical outcomes in patients with upper gastrointestinal bleeding.

AIM: Upper gastrointestinal bleeding (UGIB) is a very frequently encountered condition that has a high morbidity and which increases treatment costs. Duration of hospital stay and mortality increases in patients with UGIB complicated by acute kidney injury (AKI). The aim of this study was to reveal risk factors in patients with UGIB developing AKI and to compare clinical outcomes and hospital costs between patients with UGIB developing AKI and those with UGIB not developing AKI. MATERIAL AND METHODS: This retrospective study included 245 patients admitted to the emergency unit and the intensive care unit for internal diseases at Ankara Numune Education and Research Hospital, Turkey. RESULTS: The difference in mortality rates between the patients with AKI and those without AKI was significant (p < 0.001). The mean duration of intensive care unit stay was 0.2 ± 1.1 days in the patients without AKI (n = 143) and 2.5 ± 5.6 days in the patients with AKI. It was significantly higher in the patients with AKI (p < 0.001). Hospital stay was significantly longer in the patients with AKI than those without AKI, and as severity of AKI increased, hospital stay became considerably longer (p < 0.001). Hospital costs were significantly higher in the patients with AKI than those without AKI, and as severity of AKI increased, hospital costs considerably rose (p < 0.001). CONCLUSION: AKI is a condition that lengthens hospital stay, increases hospital costs and creates a burden on health care systems. Detect kidney injury earlier and administering an appropriate treatment can improve clinical outcomes in patients with UGIB developing AKI.