Abstract: TH-PO1165
Remote Ischemic Preconditioning Can Prevent Contrast-Induced AKI (CIAKI) by Reducing Neutrophil Extracellular Traps (NETs)
Session Information
- Late-Breaking Science Posters
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Ma, Mengqing, Nanjing First Hospital, Nanjing, Jiangsu, China
- Wan, Xin, Nanjing First Hospital, Nanjing, Jiangsu, China
- Cao, Changchun, Sir Run Run Hospital Nanjing Medical University, Nanjing, Jiangsu, China
Background
To explore the protective effect of remote ischemic preconditioning (RIPC) in CIAKI by reducing NETs.
Methods
A prospective randomized controlled trial was conducted. Patients who underwent coronary angiography (CAG) in Sir Run Run Hospital, Nanjing Medical University from October 2021 to December 2022 were enrolled in the RIPC group and the control group at a 1:1 ratio. Patients in the RIPC group were inflated/deflated with a sphygmomanometer cuff to cause unilateral upper limb ischemia and reperfusion. During inflation, the pressure was 50 mmHg higher than the patient's systolic blood pressure. The Doppler probe showed that the brachial artery blood flow was completely blocked. At the same time, the fingertip oxygen saturation of the upper limb on the test side could not be measured and the radial artery pulsation disappeared; the inflation/deflation time was 5 min/5 min, 4 cycles. Serum samples were collected from each group of patients before, 2 hours after and 12 hours after CAG, and the levels of MPO, NE and IL-33 were detected.
Results
A total of 100 eligible CAG patients were included in this study, and the incidence of CIAKI was 11%. The incidence of CIAKI in the RIPC group and the control group was (6% vs 16%, P<0.001). There were significant differences in MPO, NE and IL-33 before and after angiography, and their expression gradually increased 2h and 12h after CAG. The levels of MPO, NE and IL-33 in the RIPC group after surgery were significantly lower than those in the control group. The levels of MPO, NE and IL-33 in CIAKI patients at 2h and 12h after surgery were significantly higher than those in non-CIAKI patients. The results of AUC showed that the performance of the clinical model in predicting CIAKI was 0.767. NE (0.873, 95% CI 0.803-0.943, P<0.001), MPO (0.882, 95% CI 0.813-0.951, P<0.001) and IL-33 (0.844, 0.766-0.921, P<0.001) at 12 hours after surgery had better prediction of CIAKI. After combining with clinical indicators, the AUC was 0.909 (0.829-0.989, P<0.001), which significantly improved the prediction performance of CIAKI.
Conclusion
RIPC before angiography can reduce the level of NETs, reducing the incidence of CIAKI. Serum MPO, NE and IL-33 12 hours after CAG can better predict the occurrence of CIAKI and improve the predictive effect of the CIAKI clinical model.
Funding
- Other NIH Support