Cardiovascular mortality among patients with diffuse large B-cell lymphoma: a population-based study.

We aim to investigate cardiovascular mortality risk among diffuse large B-cell lymphoma (DLBCL) patients and explore cardiovascular mortality trends in the past decades in United States. We extracted data from the Surveillance, Epidemiology, and End Results database for adult patients diagnosed with DLBCL between 1975 and 2019. Standardized mortality ratio, joinpoint regression analysis, and competing risk model were analyzed. Overall, 49,918 patients were enrolled, of whom 4167 (8.3%) cardiovascular deaths were observed, which was 1.22 times the number expected (95%CI, 1.19-1.26). During 1985-2019, the incidence-based cardiovascular mortality rate increased by 0.98% per year (95%CI, 0.58-1.39%), with statistically significant increases in age groups younger than 75 years. The cumulative mortality from cardiovascular disease increased by age but never exceeded that from DLBCL. Older age, male sex, earlier year of diagnosis, lower tumor stage at diagnosis, chemotherapy, radiotherapy, and surgery were all poor prognostic factors for cardiovascular mortality.

First Report of Black Leaf Spot Caused by Epicoccum latusicollum on Chinese Yam in China.

Chinese yam (Dioscorea polystachya Turczaninow cv. Tiegun), which belongs to the family Dioscoreaceae, is widely cultivated throughout China due to its high economic and medicinal value. In June 2023, black leaf spots on Chinese yam (cv. Purple 1) were observed in Nanchang city (28.45° N, 115.49° E) of Jiangxi province, southeastern China. The incidence of the disease ranged between 70 and 85% of plants, and up to 30% of the leaves per plant were affected in the field over a 2-week period of study. Infected foliage displayed brown necrotic lesions, elliptical or irregular, with yellow halo at the edge of the lesion (0.5 to 3 cm diam.). To identify the causal agent, 32 symptomatic leaves of eight symptomatic plants were collected. Small pieces from the margin of necrotic leaf tissue (about 3 x 3 mm) were surface sterilized in 75% ethanol for 30 s followed in 0.1% HgCl2 for 1 min, and washed three times with ddH2O. Then, the pieces were transferred onto potato dextrose agar (PDA) plates and incubated at 26°C for 3 days with a 12-h light-dark cycle. From the 32 isolates, 21 exhibited similar morphology after hyphal tipping resulting in an isolation frequency of 65.6%. Colonies on PDA were initially white aerial hyphae but became grayish with age, and a reddish orange pigment on the underside. After 16 days of incubation, pycnidia were observed, which were dark, spherical or flat spherical, and 64.1 to 172.5 µm (n = 25) in diameter. Conidia were ellipsoidal, aseptate, hyaline, and 4.1 to 5.6 × 1.8 to 2.7 µm (n = 80). In addition, a blackish green discoloration was produced on malt extract agar (MEA) using the NaOH spot test. The isolates were tentatively identified as Epicoccum spp. based on morphological characteristics (Chen et al. 2017). Isolate AYZ-1 was randomly selected for identification and pathogenicity testing. Genomic DNA of the isolate (AYZ-1) was extracted and amplified by polymerase chain reaction (PCR) using ITS1/ITS4 for the internal transcribed spacer (ITS) region (White et al. 1990), Btub2Fd/Btub4Rd for the ß-tubulin (TUB) region (Woudenberg et al. 2009), LROR/LR7 for the large ribosomal RNA gene (LSU) region (Rehner and Samuels 1994), and RPB2-5F2/fRPB2-7cR for RNA polymerase II second largest subunit (RPB2) region (Liu et al. 1999), respectively. The concatenated sequences (GenBank Accession No. OR574165, OR567827, OR574166, OR567828, respectively) shared 99.8 to 100% identity with Epicoccum latusicollum (OP788080, MN329871, OR428532, and OL422485, respectively). A neighbor-joining phylogenetic tree was generated based on the concatenated sequences in MEGA7, placed isolate (AYZ-1) within E. latusicollum. To fulfill Koch's postulates, healthy leaflets from three one-year-old Chinese yam (cv. Purple 1) were used as inoculation materials, using isolate AYZ-1. Two sites of each leaf were wounded with a sterile needle and covered with a piece of cotton drenched with 200 µL spore suspension (106 conidia/mL) on the left sides, while sterilized water served as the control on the right sides of leaves. All inoculated leaves were covered with clear polyethylene bags for 24 h. Plants were grown outdoors at a daily average temperature of 26°C with relative humidity over 45%. After 7 days of incubation, the leaves showed the same symptoms as the original diseased leaves. The E. latusicollum isolate was re-isolated from diseased leaves and confirmed by morphology and sequencing analysis, fulfilling Koch's postulates. E. latusicollum has been previously reported to cause black root on yam in China's south-western province of Sichuan (Han et al. 2019). Meanwhile, leaf spot have been reported on many plants by this genus, such as tobacco (Guo et al. 2020) and banana (Liu et al. 2023). According to our knowledge, this is the first report of E. latusicollum causing black leaf spot on Chinese yam in China. This finding will provide an important reference for understanding the biology of E. latusicollum and the distribution of the disease, but more research is needed to determine if management is warranted.

Mechanisms by which chloropicrin fumigation promotes soil potassium conversion and absorption.

Fumigation of soil using chloropicrin has been proven to significantly affect soil nutrient cycling, but the mechanism by which soil potassium conversion and plant uptake is promoted remains unclear. In this study, we conducted a fumigation experiment to investigate the effects of chloropicrin soil fumigation on the conversion of soil potassium post-fumigation (days 7-70), and its mechanisms, tomatos were planted in fumigated and non-fumigated soils to enable further comparisons. Results showed that the content of rapidly available potassium and available potassium decreased by 16-24% and 17-23% at day 28 respectively, when tomato was planted in chloropicrin-fumigated soils compared to the non-fumigated soils. The potassium content of tomato planted in fumigated soil was significantly higher than that planted in non-fumigated soil (30.3 vs. 21.9 mg g-1 dry weight). Chloropicrin fumigation resulted in a significant change in the soil bacterial and fungal community structures, and trigged a long-term (at least 70-day) decrease in microbial diversity. Network analysis showed that chloropicrin soil fumigation changed microbial co-occurrence patterns by decreasing bacterial total links, nodes, and average degree, and increasing fungal total links, nodes, and average degree. Chloropicrin fumigation caused significant changes in the relative abundance of Bacillus species, which are involved in potassium dissolution. Structural equation model (SEM) suggested that fumigation with chloropicrin enhanced the contribution of soil potassium to tomato growth and reduced the contribution of bacterial communities. Together, the results of our study help in understanding the crop yield enhancement mechanism of soil fumigation.

Control of the Invasive Agricultural Pest Pomacea canaliculata with a Novel Molluscicide: Efficacy and Safety to Nontarget Species.

The golden apple snail Pomacea canaliculata is an invasive pest that causes extensive damage to agricultural production. P. canaliculata is also an intermediate host of Angiostrongylus cantonensis, which causes human eosinophilic meningitis. In this study, the molluscicidal activity and safety profile of a novel molluscicide PBQ [1-(4-chlorophenyl)-3-(pyridin-3-yl)urea] were evaluated. PBQ exhibited strong molluscicidal potency against adult and juvenile snails (LC50 values of 0.39 and 0.07 mg/L, respectively). In field trials, PBQ killed 99.42% of the snails at 0.25 g a.i./m2. An acute toxicity test in rats demonstrated that PBQ is a generally nonhazardous chemical. PBQ is also generally safe for nontarget organisms including Brachydanio rerio, Daphnia magna, and Apis mellifera L. Transcriptomics analysis revealed that PBQ had a significant impact on the carbohydrate and lipid metabolism pathways, which provided insights into its molluscicidal mechanism. These results suggest that PBQ could be developed as an effective and safe molluscicide for P. canaliculata control.

Genome-wide identification and functional analysis of long non-coding RNAs in Chilo suppressalis reveal their potential roles in chlorantraniliprole resistance.

Long non-coding RNAs, referred to as lncRNAs, perform essential functions in some biological processes, including reproduction, metamorphosis, and other critical life functions. Yet, lncRNAs are poorly understood in pesticide resistance, and no reports to date have characterized which lncRNAs are associated with chlorantraniliprole resistance in Chilo suppressalis. Here, RNA-seq was performed on two strains of C. suppressalis exposed to chlorantraniliprole: one is a susceptible strain (S), and the other is a resistant strain (R). In total, 3,470 lncRNAs were identified from 40,573 merged transcripts in six libraries, including 1,879 lincRNAs, 245 intronic lncRNAs, 853 sense lncRNAs, and 493 antisense lncRNAs. Moreover, differential expression analysis revealed 297 and 335 lncRNAs upregulated in S and R strains, respectively. Differentially expressed (DE) lncRNAs are usually assumed to be involved in the chlorantraniliprole resistance in C. suppressalis. As potential targets, adjacent protein-coding genes (within <1000 kb range upstream or downstream of DE lncRNAs), especially detoxification enzyme genes (cytochrome P450s, carboxyl/cholinesterases/esterases, and ATP-binding cassette transporter), were analyzed. Furthermore, the strand-specific RT-PCR was conducted to confirm the transcript orientation of randomly selected 20 DE lincRNAs, and qRT-PCR was carried out to verify the expression status of 8 out of them. MSTRG.25315.3, MSTRG.25315.6, and MSTRG.7482.1 were upregulated in the R strain. Lastly, RNA interference and bioassay analyses indicated overexpressed lincRNA MSTRG.7482.1 was involved in chlorantraniliprole resistance. In conclusion, we represent, for the first time, the genome-wide identification of chlorantraniliprole-resistance-related lncRNAs in C. suppressalis. It elaborates the views underlying the mechanism conferring chlorantraniliprole resistance in lncRNAs.

Exendin-4 promotes bone formation in diabetic states via HDAC1-Wnt/ß-catenin axis.

Exendin-4 has been found to have hypoglycemic effect and prevent bone loss in diabetic patients, but its mechanism of preventing bone loss is still unclear. In this study, high-fat diet combined with streptozotocin was used to establish type 2 diabetes mellitus (T2DM) mice, and bone marrow mesenchyme stem cells (BMSCs) were isolated for osteogenic induction in vitro. Alizarin red staining and ALP activity detection were used to observe the effect of exendin-4 on osteogenic differentiation of BMSCs. Western blot was used to detect the proteins expression in BMSCs. In vivo, the effects of exendin-4 treatment on body weight, blood glucose, bone density and bone quality of T2DM mice were observed by treatment with exendin-4. The results showed that exendin-4 promoted osteogenic differentiation of T2DM derived BMSCs, down-regulated histone deacetylase 1 (HDAC1) and p-ß-Catenin proteins expression, and up-regulated Wnt3, ß-Catenin and runt-related transcription factor 2 (Runx 2) proteins expression. In vivo, exendin-4 effectively suppressed the blood glucose and increased body weight of T2DM mice, and significantly improved bone density and bone quality of the right tibia. Interestingly, by over-expression of HDAC1 in BMSCs, the effect of exendin-4 on promoting osteogenic differentiation of BMSCs was attenuated, and the regulation of Wnt3a, ß-Catenin, p-ß-Catenin or Runx2 proteins were reversed. By injecting adenovirus containing HDAC1 into the right tibia of mice, the effect of exendin-4 on bone density and bone quality of T2DM mice was significantly attenuated. All above results suggest that the HDAC1-Wnt/ß-Catenin signal axis is involved in the anti-diabetic bone loss effect of exendin-4, and HDAC1 may be the target of exendin-4.

Constitutive overexpression of cytochrome P450 monooxygenase genes contributes to chlorantraniliprole resistance in Chilo suppressalis (Walker).

BACKGROUND: The rice striped stem borer (SSB), Chilo suppressalis (Walker), which is one of the most economically important phytophagous pests, has developed resistance to multiple insecticides. The resistance of SSB against chlorantraniliprole has been investigated in detail. However, the mechanism of its metabolic resistance has rarely been studied. RESULTS: A field population from Wuhu City, China was used to establish chlorantraniliprole resistant and susceptible strains (WHR and WHS) by laboratory continuous selection. Enzyme activities data suggested the potential involvement of cytochrome P450 monooxygenase in WHR. CYP6CV5, CYP9A68, CYP321F3, and CYP324A12 were significantly overexpressed in WHR (from 4.48 to 44.88-fold). These four P450 genes were expressed in the late developmental stages of WHR; however, they were almost absent during the egg stage. In addition, their expressions were much more sensitive to chlorantraniliprole induction in WHR than in WHS. Injection of individual and mixture dsRNAs reduced the expression of the four target genes (55.2-73.2% and 43.2-50.2%, respectively) and caused significant larvae mortality (55.1-65.1% and 88.2%, respectively). CONCLUSION: Multiple overexpressed P450 genes were potentially associated with chlorantraniliprole resistance, as confirmed by the RNA interference (RNAi) assay. Our findings suggested that metabolic resistance to chlorantraniliprole might be mediated by P450s. © 2018 Society of Chemical Industry.

Chlorantraniliprole resistance and its biochemical and new molecular target mechanisms in laboratory and field strains of Chilo suppressalis (Walker).

BACKGROUND: The rice striped stem borer (SSB), Chilo suppressalis (Walker), is one of the most economically important and destructive rice pests in China. To date, the efficiency of conventional insecticides has decreased greatly because of the development of high resistance. Since the introduction of chlorantraniliprole in 2008, SSB has presented resistance issues. RESULTS: In this study, laboratory resistant strains R1 and R2 [resistance ratio (RR) of 38.8 and 110.4, respectively] were established and a field population HR (RR of 249.6) was collected. Synergist assessment and enzyme activity data suggested the potential involvement of P450s and esterases in the resistance mechanism. No target (ryanodine receptor, RyR) mutation was found in R1, but a novel mutation Y4667D was found in R2. At the same position of RyR in HR strain, Y4667D and Y4667C were observed at low frequencies. In addition, the conserved mutation I4758M was found with a frequency of 94.4%. RyR mRNA expression was significantly lower in R1, R2 and HR than in S. When treated with chlorantraniliprole, RyR mRNA expression in all four strains was downregulated to ∼ 50%. CONCLUSIONS: A comprehensive analysis, including biochemical, target mutations and target mRNA expression, was conducted in an attempt to interpret the chlorantraniliprole resistance mechanism in both laboratory and field SSB strains. © 2017 Society of Chemical Industry.

Large-scale identification of differentially expressed genes during pupa development reveals solute carrier gene is essential for pupal pigmentation in Chilo suppressalis.

Insects undergo metamorphosis, involving an abrupt change in body structure through cell growth and differentiation. Rice stem stripped borer (SSB), Chilo suppressalis, is one of the most destructive rice pests. However, little is known about the regulation mechanism of metamorphosis development in this notorious insect pest. Here, we studied the expression of 22,197 SSB genes at seven time points during pupa development with a customized microarray, identifying 622 differentially expressed genes (DEG) during pupa development. Gene ontology (GO) analysis of these DEGs indicated that the genes related to substance metabolism were highly expressed in the early pupa, which participate in the physiological processes of larval tissue disintegration at these stages. In comparison, highly expressed genes in the late pupal stages were mainly associated with substance biosynthesis, consistent with adult organ formation at these stages. There were 27 solute carrier (SLC) genes that were highly expressed during pupa development. We knocked down SLC22A3 at the prepupal stage, demonstrating that silencing SLC22A3 induced a deficiency in pupa stiffness and pigmentation. The RNAi-treated individuals had white and soft pupa, suggesting that this gene has an essential role in pupal development.

Impact of an Early Decrease in Systolic Blood Pressure on The Risk of Contrast-Induced Nephropathy after Percutaneous Coronary Intervention.

BACKGROUND: The early postprocedural period was thought to be the rush hour of contrast media excretion, causing rapid and prolonged renal hypoperfusion, which was the critical time window for contrast-induced nephropathy (CIN). METHODS: 349 consecutive patients were enrolled into the study. The relation between an early postprocedural decrease in systolic blood pressure (SBP) and the risk of CIN was assessed using multivariate logistic regression. RESULTS: A postprocedural decrease in SBP was observed in 63% of patients and CIN developed in 28 (8.0%) patients. The CIN group had a lower postprocedural SBP (114.5±13.5 vs. 123.7±15.6mmHg, P=0.003) and a greater postprocedural decrease in SBP (16.2±19.1 vs. 5.9±18.7mmHg, P=0.005) than the no-CIN group. ROC analysis revealed that the optimum cutoff value for the SBP decrease in detecting CIN was >10mmHg (sensitivity 60.7%, specificity 59.5%, AUC=0.66). Multivariate logistic regression analysis found that a postprocedural decrease in SBP >10mmHg was a significant independent predictor of CIN (OR 2.368, 95%CI: 1.043-5.379, P=0.039), after adjustment for other risk factors. CONCLUSION: An early moderate postprocedural decrease in SBP may increase the risk of CIN in patients undergoing PCI.

Cloning of Two Acetylcholinesterase Genes and Analysis of Point Mutations Putatively Associated with Triazophos Resistance in Chilo auricilius (Lepidoptera: Pyralidae).

Acetylcholinesterase (AChE) is the target of organophosphate (OP) and carbamate insecticides. Mutations in the AChE gene (ace) leading to decreased insecticide susceptibility is the main resistance mechanism in insects. In this study, two Chilo auricilius acetylcholinesterase genes, designated as Caace1 and Caace2, were cloned using RT-PCR and RACE. Caace1 cDNA is 2534 bp, with ORF of 2082 bp, and it encodes an acetylcholinesterase 1 (CaAChE1) protein comprising a calculated 693 amino acid (aa) residues. Caace2 cDNA contains 2280 bp, with a full-length ORF of 1917 bp, encoding acetylcholinesterase 2 (CaAChE2) comprising a calculated 638 aa residues. At the aa level, CaAChE1 displays the highest similarity (97%) with the Chilo suppressalis AChE1, and CaAChE2 shows the highest similarity with the C. suppressalis AChE2 (99%). From the restriction fragment length polymorphism (RFLP) PCR (RFLP-PCR) analysis, one mutation in Caace1, similar to the ace1 mutation associated with triazophos resistance in C. suppressalis, was detected. Detailed examination of field populations of C. auricilius indicated this resistance mutation in C. auricilius is still quite infrequent. Based on the assay of AChE activity and RFLP-PCR testing, an individual that contains resistance mutation has lower AChE activities, while the individual that does not contain the resistance mutation has higher AChE activities. This study provides a basis for future investigations into the mechanism of OP resistance in C. auricilius, as well as a guidance for C. auricilius control with reasonable choice of pesticides.

Safe limits of contrast vary with hydration volume for prevention of contrast-induced nephropathy after coronary angiography among patients with a relatively low risk of contrast-induced nephropathy.

BACKGROUND: Few studies have investigated the safe limits of contrast to prevent contrast-induced nephropathy (CIN) based on hydration data. We aimed to investigate the relative safe maximum contrast volume adjusted for hydration volume in a population with a relatively low risk of CIN. METHODS AND RESULTS: The ratios of contrast volume-to-creatinine clearance (V/CrCl) and hydration volume to body weight (HV/W) were determined in patients undergoing cardiac catheterization. Receiver-operator characteristic curve analysis based on the maximum Youden index was used to identify the optimal cutoff for V/CrCl in all patients and in HV/W subgroups. Eighty-six of 3273 (2.6%) patients with mean CrCl 71.89±27.02 mL/min developed CIN. Receiver-operator characteristic curve analysis indicated that a V/CrCl ratio of 2.44 was a fair discriminator for CIN in all patients (sensitivity, 73.3%; specificity, 70.4%). After adjustment for other confounders, V/CrCl >2.44 continued to be significantly associated with CIN (adjusted odds ratio, 4.12; P<0.001) and the risk of death (adjusted hazard ratio, 2.62; P<0.001). The mean HV/W was 12.18±7.40. We divided the patients into 2 groups (HV/W ≤12 and >12 mL/kg). The best cutoff value for V/CrCl was 1.87 (sensitivity, 67.9%; specificity, 64.4%; adjusted odds ratio, 3.24; P=0.011) in the insufficient hydration subgroup (HV/W, ≤12 mL/kg; CIN, 1.32%) and 2.93 (sensitivity, 69.0%; specificity, 65.0%; adjusted odds ratio, 3.04; P=0.004) in the sufficient hydration subgroup (HV/W, >12 mL/kg; CIN, 5.00%). CONCLUSIONS: The V/CrCl ratio adjusted for HV/W may be a more reliable predictor of CIN and even long-term outcomes after cardiac catheterization. We also found a higher best cutoff value for V/CrCl to predict CIN in patients with a relatively sufficient hydration status, which may be beneficial during decision-making about contrast dose limits in relatively low-risk patients with different hydration statuses.

Preprocedural N-terminal pro-brain natriuretic peptide (NT-proBNP) is similar to the Mehran contrast-induced nephropathy (CIN) score in predicting CIN following elective coronary angiography.

BACKGROUND: N-terminal pro-brain natriuretic peptide (NT-proBNP) has been associated with important risk factors for contrast-induced nephropathy (CIN). However, few studies have investigated the predictive value of NT-proBNP itself. This study investigated whether levels of preprocedural NT-proBNP could predict CIN after elective coronary angiography as effectively as the Mehran CIN score. METHODS AND RESULTS: We retrospectively observed 2248 patients who underwent elective coronary angiography. The predictive value of preprocedural NT-proBNP for CIN was assessed by receiver operating characteristic and multivariable logistic regression analysis. The 50 patients (2.2%) who developed CIN had higher Mehran risk scores (9.5 ± 5.1 versus 4.8 ± 3.8), and higher preprocedural levels of NT-proBNP (5320 ± 7423 versus 1078 ± 2548 pg/mL, P<0.001). Receiver operating characteristic analysis revealed that NT-proBNP was not significantly different from the Mehran CIN score in predicting CIN (C=0.7657 versus C=0.7729, P=0.8431). An NT-proBNP cutoff value of 682 pg/mL predicted CIN with 78% sensitivity and 70% specificity. Multivariable analysis suggested that, after adjustment for other risk factors, NT-proBNP >682 pg/mL was significantly associated with CIN (odds ratio: 4.007, 95% CI: 1.950 to 8.234; P<0.001) and risk of death (hazard ratio: 2.53; 95% CI: 1.49 to 4.30; P=0.0006). CONCLUSIONS: Preprocedural NT-proBNP >682 pg/mL was significantly associated with the risk of CIN and death. NT-proBNP, like the Mehran CIN score, may be another useful and rapid screening tool for CIN and death risk assessment, identifying subjects who need therapeutic measures to prevent CIN.

Contrast Volume-to-Creatinine Clearance Ratio Predicts the Risk of Contrast-Induced Nephropathy After Percutaneous Coronary Intervention in Patients With Reduced Ejection Fraction.

We determined a relatively safe contrast media volume-to-creatinine clearance (V/CrCl) cutoff value to avoid contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in patients (n = 111) with reduced ejection fraction (<40%). Improved prediction of CIN in these patients would be useful. Multivariate regression models were used to evaluate whether V/CrCl is an independent risk factor for CIN. Nine (8.1%) patients developed CIN. The V/CrCl was significantly (P = .023) higher in patients with CIN than in those without. The incidence of CIN in patients with the highest tertile of V/CrCl was significantly higher than the middle and lowest tertiles (18.4% vs. 2.7% and 2.8%; P = .013). After adjusting for other potential risk factors, a V/CrCl ≥3.87 remained significantly associated with risk of CIN. A V/CrCl <3.87 might be valuable in predicting the risk of CIN in patients with reduced ejection fraction undergoing PCI.

[Association between high-sensitivity C-reactive protein and contrast-induced nephropathy after primary percutaneous coronary intervention].

OBJECTIVE: To explore the association between high-sensitivity C-reactive protein (hs-CRP) and contrast-induced nephropathy (CIN) in patients with ST-segment elevated myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) . METHODS: A total of 220 STEMI patients undergoing primary PCI from Guangdong general hospital were recruited. Patients were divided into four groups according to the quartile of hs-CRP (Q1 group:hs-CRP < 6.26 mg/L,Q2 group:6.26-14.44 mg/L, Q3 group:14.45-33.08 mg/L, Q4 group:hs-CRP > 33.08 mg/L) . Baseline data, CIN incidence and other in-hospital outcomes were compared among groups. CIN was defined as an increase in serum creatinine of more than 5 mg/L from baseline within 48-72 hours after contrast media exposure. Receiver operator characteristics (ROC) curves and multivariate logistic regression were used to assessed the correlation between hs-CRP and CIN. RESULTS: CIN occurred in 21 (9.8%) patients. CIN incidence of hs-CRP quartitles were 1.8%(1/55), 1.8% (1/55), 14.5% (8/55) and 20.0% (11/55) (P-trend < 0.01), respectively. In-hospital death (P-trend > 0.05) , required renal replace therapy (P-trend > 0.05) were similar among groups. ROC analysis revealed that the optimal cutoff value of hs-CRP to predict the onset of CIN was 16.85 mg/L (sensitivity: 81.0%, specificity: 61.8%, AUC: 0.748). Univariate logistic analysis showed that hs-CRP was strongly related with CIN incidence (OR = 6.88,95%CI:2.23-21.21, P < 0.01). Multivariate logistic regression analysis showed that after adjusting other traditional risk factors including female gender, anemia, ACEI/ARB use, IABP support, LVEF < 40%, age > 75 years, baseline eGFR and diabetes, hs-CRP > 16.85 mg/L was still a significant independent predictor of CIN in patients with STEMI undergoing primary PCI. Additionally, age > 75 years (OR = 7.27,95%CI:1.85-28.63, P < 0.01), eGFR (OR = 6.38,95% CI:1.48-27.41, P < 0.05) were also independent risk factors of CIN. CONCLUSIONS: hs-CRP is positively correlated with CIN incidence. STEMI patients with higher hs-CRP level post PCI is at higher risk of developing CIN.

Use of the contrast volume or grams of iodine-to-creatinine clearance ratio to predict mortality after percutaneous coronary intervention.

BACKGROUND: Few studies have assessed the predictive value of the ratio of the contrast media volume or grams of iodine to the creatinine clearance (V/CrCl or g-I/CrCl, respectively) for the risk of contrast-induced nephropathy (CIN) and mortality after percutaneous coronary intervention (PCI). METHODS: The association between V/CrCl and mortality was prospectively evaluated in 1,135 consecutive patients undergoing PCI. Cox regression models were used to adjust for the V/CrCl ratio and other confounding factors for risk of death within 1 year. RESULTS: Fifty-five patients (4.84%) developed CIN. The 1-year mortality was higher in patients with a V/CrCl ratio >2.62 (g-I/CrCl >0.97) than in others (4.44% vs 0.40%; P < .001). After adjusting for other risk factors, the 1-year mortality risk remained associated with increased V/CrCl ratio. The risk of death was significant for V/CrCl >2.62 (adjusted risk ratio [RR] for death 2.605, 95% CI 1.040-6.529, P = .041), V/CrCl >3.0 (g-I/CrCl >1.11) (adjusted RR 4.338, 95% CI 1.689-11.142, P = .002), and V/CrCl >3.7 (g-I/CrCl >1.37) (adjusted RR 2.557, 95% CI 1.162-5.627, P = .002). CONCLUSION: The data further support the prognostic significance of calculating the V/CrCl ratio to predict the relative maximum contrast volume during PCI. Use of a contrast dose determined based on the estimated renal function with a planned V/CrCl ratio <3.7 (g-I/CrCl <1.37) and preferably <2.62 (g-I/CrCl <0.97) might be valuable in reducing the risks of CIN and even death after PCI.