Fatty Acid Binding Protein and AKI after PCI Cardiovascular & Haematological Disorders-Drug Targets, 2019, Vol.

ogical Disorders-Drug Targets, 2019, Vol. 19, No. 0 3

Table 1. Demographic and clinical characteristics of patient. The data are frequency (percent) or average ± standard deviation
(min-max).

P-Value   Severe AkI(n=6)   Any AkI(n=6)   Without AKI(n=72)   Variant  

0.025   2 (33.3)   15 (88.2)   36 (50)   Gender(men)  

0.36   70±14.28   58±8.63   58.88±10.26   Age in year  
(49-87)   (44-75)   (40-83)  
0.261   27.17±2.32   25.23±2.84   25.24±3.22   BMI(kg/m2)  
(25-30)   (20-30)   (19-36)  
0.003   4(66.7)   12(70.6)   33(45.8)   DM(Yes)  
0.027   5(83.3)   15(88.2)   43(45%)   HTN(Yes)  
0.702   3(50)   3(17.6)   16(22.2)   DLP(Yes)  
0.26   2(33.3)   11(64.7)   31(43.0)   Smoker(Yes)  
0.999   4(66.7)   4(23.5)   25(34.7)   ACS(Yes)  
0.013   5(83.3)   2(11.8)   6(8.3)   Positive Trop  
0.738   5:1 Vessle CAD(83.3)   14:1VessleCAD(82.3)   62(86.1):1Vessle CAD   Number of coronary artery
10(13.8):<1Vessle   under PCI  
<0.0001   37.5±6.89(30-50)   40.88±10.64(20-55)   48.96±6.11(35-60)   LVEF (%)  
0.104   183.33±51.64(150-250)   232.35±49.82(150-300)   215.28±46.45(150-350)   Contrast Volume  
<0.001   5.67±1.37(4-7)   4.12±0.63(3-6)   1.47±0.71(1-3)   Number of hospitalization  
BMI: body mass index; DM: diabetes mellitus; HTN: hypertension; DLP: dyslipidemia; ACS: acute coronary syndrome; PCI: percutaneous coronary intervention; LVEF: left
ventricular ejection fraction.

Table 2. Comparison of Laboratory Parameters before and after PCI. The data are average ± standard deviation (min-max).  

Variant   Time of Assey   Without AKI(n=72)   Any AKI(n=17)   Severe AKI(n=6)   P-Value  

GFR(mg/dl)   Preoperative   82.79±16.44   89.76±27.79   68.5±19.21   0.144  

(45-125)   (63-140)   (50-97)  
Postoperative   81.96±16.61   58.82±14.16   39.17±12.81   <0.001  
(45-125)   (42-95)   (30-60)  
Creatinine(mg/dl)   Preoperative   0.96±0.12   0.95±0.23   1.07±0.17   0.236  
(0.7-1.3)   (0.6-1.3)   (0.8-1.3)  
Postoperative   0.97±0.13   1.42±0.24   2.12±0.38   <0.001  
(0.7-1.3)   (1-1.8)   (1.6-2.7)  
HFABP(ng/mL)   Preoperative   2.12±0.91   5.78±0.81   6.49±0.66   <0.001  
(0.7-5.06)   (4.56-7.71)   (5.54-7.31)  
Postoperative   5.64±1.69   11.73±1.72   12.98±1.77   <0.001  
(2.5-10.95)   (9.9-16)   (10.45-15.05)  
GRF: Glomerular filtration rate, Nano-gram per milliliter :ng/mL.

indicated that there is a significant relationship between the
incidence of AKI after PCI with diabetes, hypertension
(HTN), positive troponin, left ventricular ejection fraction
(LVEF) and hospitalization time (P<0.05). However, there
was no significant difference between the levels of Body
mass index (BMI), Acute coronary syndrome (ACS), smoking,
number of vessels underwent PCI, and the amount of
contrast agent used, with AKI (P> 0.05). The evaluation of
renal function before and after surgery is shown in Table 2.
The results show that there was a significant difference in
terms of two factors of GFR and Cr between the groups just
after the operation and after the AKI. In the AKI group, GFR
decreased and Cr increased (compared to the non-AKI group),
and these changes were statistically significant. There was
no significant difference between pre-operative GFR and Cr
levels in 3 AKI status (P <0.05). Similarly, there was a
significant difference in the rate of HFABP marker before
PCI between the uncomplicated groups of AKI and the AKI
group, and after PCI between the 3 AKI status (P <0.05).
HFABP unit is Nano-gram per milliliter (ng/mL). The ROC
(AUC) curve for HFABP variations is shown in Fig. 1, and
the area under the ROC curve for this variable indicates its
correctness, is equal to 0.952, so this variable has excellent
diagnostic correctness to distinguish AKI individuals from non-
AKI patients. The AUC of this variable is also statistically
significant (p<0.001). Our results show that a group of
patients who have an AKI after PCI are often identified
before surgery and can be identified using the HFABP
marker. However, its use requires accurate measurement of the
sensitivity and specificity of its details in Table 3 below.
4 Cardiovascular & Haematological Disorders-Drug Targets, 2019, Vol. 19, No. 0
Fig. (1).
4. DISCUSSION
  presence of positive troponin has a statistically significant
One of the most important problems caused by PCI is the
occurrence of AKI, which can slow down kidney function in
the future years, so to identify and prevent the risk of the
patient seem important. In this regard, the present study was
conducted to evaluate the factors for evaluation of AKI after
PCI. In the present study, we attempted to reduce the number
of fault gender, and in our study, the difference between
women and men was 5.6%. The incidence of AKI in this
study was higher in men than in women. In the study
conducted by Wi et al., most AKI patients were men [19]. In
this study, there were significant relationships between the
AKI and gender of the patients, and the rate of AKI in male
patients was significantly higher than women. Similar results
were found in the study by Tsai et al. [3], who evaluated a
significant number of patients. The level of AKI in men was
higher even at higher stages, and also a significant difference
was observed between the incidence of AKI and the gender
of people. In our study, diabetes was associated with the
development of AKI after PCI, and there was a significant
difference between different groups. The study by Manabe et
al found opposite results [20]. The results of our study
confirm the results of the study conducted by Malayszko et
al., as well as the study conducted by Tsai et al. [3, 21].
Other significant parameters, showing significant differences
between the two complicated and uncomplicated groups,
Table 3. Sensitivity, specificity, positive and negative predictive value, index and accuracy for HFABP changes in differentiating
between AKI and non-AKI individuals.
Cut Sensitivity Spesifity
point (˙/.) (˙/.)
4.69 95.65 84.72
Haybar et al.
included the presence of HTN, which has been significantly
different in our study among several groups such as the study
conducted by Katoh et al. [21]. We find a significant
relationship between the AKI after the injection of contrast
agents in patients and their blood pressure. In the present
study, there was no significant relationship between
dyslipidemia and ACS and smoking with the development of
AKI, and the patients with these characteristics did not differ
significantly in the development of any AKI with non-
complicated patients. In a study conducted by Manabe et al.
[19], who investigated lipid profiles, none of the parameters
of lipid profile were associated with the development of this
complication. A study conducted by Tsai et al. [2] confirm
the results of our study. There is a significant relationship
between DLP and smoking with AKI; this effect could be
due to their wider study and the evaluation of several
previous studies. Another important parameter related to
AKI was the age of the patients so that there was a
significant difference between the age of uncomplicated
patients and other groups. A study conducted by Doi et al.
[22], as well as the study conducted by Tsai et al. [2], have
confirmed the results of our study and provided strong
evidence for the involvement of this parameter in AKI.
Overall, according to the results of this study, patients
undergoing PCI, are at higher risk of AKI. Moreover, the
correlation with the incidence of AKI, but in general, there is
no significant role for ACS or also, DLP, cigarette and the
number of coronary arteries under PCI. Considering the fact
that reduction of postoperative GFR and increased
postoperative Cr (and in fact, occurred AKI) in patients who
had a higher preoperative of HFABP, there was a significant
increase in postoperative HFABP; furthermore, due to the
association between the AKI with DM, HTN, HF, and
positive troponin and H-FABP was higher in patients with a
worse clinical condition such as DM or HTN and they were
at higher risk of AKI development. This association is due to
the higher probability due to the risk factor such as DM, and
HTN. Considering the relationship between HFABP levels
and the incidence of AKI in the present study, it is shown
that this marker in 4.69 Cut-point, with a specificity of
84.72, has a sensitivity of 95.65 and reliability of 87.37 and a
negative predictive value of 98.99. It also is able to identify
people at risk of AKI in a short period of time, help to
initiate faster protective and therapeutic interventions and
save many patients from more severe types of kidney
damage and reduce the post- PCI AKI after healing. Schaub
et al. (2015) found that patients with AKI had higher levels
of H-FABP before and after the operation than non-AKI
patients. They reported that pre-operative H-FABP plasma
levels could be used to categorize AKI risk and mortality
after cardiac surgery [23]. In another study, Oezkur et al.
PPV NPV Index Accuracy
(˙/.) (˙/.) (˙/.) (˙/.)
66.67 98.39 80.37 87.37