Contemporary practice patterns related to the risk of acute kidney injury in the catheterization laboratory: Results from a survey of Society of Cardiovascular Angiography and Intervention (SCAI) cardiologists

Prasad, Anand; Sohn, Aaron; Morales, Jonathan; Williams, Ken; Bailey, Steven R.; Levin, Daniel; McCullough, Peter A.; Mehran, Roxana; Lopez‐Cruz, Georgina; Harder, Joel C.

doi:10.1002/ccd.26628

Cited by 12 publications

(6 citation statements)

References 42 publications

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“…A recent landmark study of over 1.3 million PCIs by Amin et al demonstrated inconsistent and significant variation in contrast use among physicians and minimal reduction in CMV for patients at higher risk for AKI . In a recent physician survey carried out by SCAI, 40% of respondents reported estimating CMV without using a measurement technique and 40% of respondents reported not using CMV threshold limits for patients at risk of AKI …”

Section: Discussionmentioning

confidence: 99%

Minimizing radiographic contrast administration during coronary angiography using a novel contrast reduction system: A multicenter observational study of the DyeVert™ plus contrast reduction system

Gurm

Mavromatis

Bertolet

et al. 2018

Cathet Cardio Intervent

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Objective To evaluate contrast media (CM) volume (CMV) saved using the DyeVert™ Plus Contrast Reduction System (DyeVert Plus System, Osprey Medical) in patients undergoing diagnostic coronary angiogram (CAG) and/or percutaneous coronary interventional (PCI) procedures performed with manual injections. Background Current guidelines advocate for monitoring and minimization of the total volume of CM in chronic kidney disease (CKD) patients undergoing invasive cardiac procedures. The DyeVert Plus System is an FDA cleared device designed to reduce CMV delivered during angiography and permit real‐time CMV monitoring. Methods We performed a multicenter, single‐arm, observational study. Eligible subjects were ≥ 18 years old with baseline estimated glomerular filtration rate (eGFR) 20–60 mL/min/1.73 m2. The primary endpoint was % CMV saved over the total procedure. A secondary objective was to evaluate adverse events (AEs) related to DyeVert Plus System or to CM use. Results A total of 114 subjects were enrolled at eight centers. Mean age was 72 ± 9 years, 72% were male, and mean body mass index was 29 ± 5. Baseline eGFR was 43 ± 11 mL/min/1.73 m2. CAG‐only was performed in 65% of cases. One hundred and five subjects were evaluable for the primary endpoint. Mean CMV attempted was 112 ± 85 mL (range 22–681) and mean CMV delivered was 67 ± 51 mL (range 12–403), resulting in an overall CMV savings of 40.1 ± 8.8% (95% CI 38.4, 41.8; P < 0.0001) per procedure. Image quality was maintained in all but one case where the system was turned off for one injection. No DyeVert Plus System‐related AEs were reported. Acute kidney injury (AKI; defined as serum creatinine rise of >0.3 mg/dL from baseline) was reported in 11 cases with seven occurring in subjects with baseline eGFR < 30 and three AKI events were attributed to CM. AKI rates increased as CMV/eGFR ratios increased. Conclusions These data suggest DyeVert Plus System use in CKD patients undergoing CAG and/or PCI results in clinically meaningful CMV savings while maintaining image quality.

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Section: Discussionmentioning

confidence: 99%

Minimizing radiographic contrast administration during coronary angiography using a novel contrast reduction system: A multicenter observational study of the DyeVert™ plus contrast reduction system

Gurm

Mavromatis

Bertolet

et al. 2018

Cathet Cardio Intervent

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“…As the prevalence of diabetes, CKD, and peripheral arterial disease (PAD) continues to rise, an increasing number of patients will present for endovascular therapy and be exposed to the risk of CI‐AKI . The use of digital subtraction imaging with ICM remains the most common angiographic approach in patients with symptomatic PAD . Pharmacologic measures to reduce the incidence of CI‐AKI have been largely ineffective—with volume expansion and minimization of ICM as the most adopted techniques to prevent this complication.…”

Section: Discussionmentioning

confidence: 99%

Contrast induced‐acute kidney injury following peripheral angiography with carbon dioxide versus iodinated contrast media: A meta‐analysis and systematic review of current literature

Prasad

Weinerman

Khan

et al. 2017

Cathet Cardio Intervent

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“…As mentioned previously, a low rate of hydration in patients of our study clearly suggests a weak understanding of both the disease and the therapy. A recent survey conducted by Prasad et al ., to evaluate contemporary practice patterns with regard to prevention of CIN in patients undergoing invasive angiography from the Society of Cardiovascular Angiography and Intervention (SCAI) member cardiologists, revealed that 96.8% of the patients believe that the acute kidney injury (AKI) risk was always important; however, there were only 64.8% cardiologists who inclined to adopt the use of standardized volume expansion protocols to prevent the occurrence of CIN23.…”

Section: Discussionmentioning

confidence: 99%

Post-Hoc Study: Intravenous Hydration Treatment in Chinese Patients with High Risk of Contrast-Induced Nephropathy Following Percutaneous Coronary Intervention

Bei

Lin

et al. 2017

Sci Rep

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Contrast-induced nephropathy (CIN) develops after the injection of iodinated contrast media. This is a post hoc analysis of the data obtained from the TRUST study, which was a prospective, multicentre, observational study conducted to evaluate the safety and tolerability of the contrast medium iopromide in patients undergoing cardiac catheterization from August 2010 to September 2011 in China, conducted to explore the current status, trends and risk predictors of hydration treatment. The status of hydration to prevent CIN in each patient was recorded. Of the total 17,139 patients from the TRUST study (mean age, 60.33 ± 10.38 years), the overall hydration usage was 46.1% in patients undergoing percutaneous coronary intervention (PCI) and 77.4%, 51.7%, and 48.5% in patients with pre-existing renal disease, diabetes mellitus, and hypertension, respectively. The proportion of hydration use increased from 36.5% to 55.5% from August 2010 to September 2011, which was independently associated with risk predictors like older age, pre-existing renal disease, hypertension, diabetes mellitus, prior myocardial infarction, ST segment elevation MI, high contrast dose, multi-vessel disease and reduced LVEF (<45%). Overall, the usage of intravenous hydration treatment for patients with a high risk of CIN following PCI was high in China.

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Contemporary practice patterns related to the risk of acute kidney injury in the catheterization laboratory: Results from a survey of Society of Cardiovascular Angiography and Intervention (SCAI) cardiologists

Cited by 12 publications

References 42 publications

Minimizing radiographic contrast administration during coronary angiography using a novel contrast reduction system: A multicenter observational study of the DyeVert™ plus contrast reduction system

Minimizing radiographic contrast administration during coronary angiography using a novel contrast reduction system: A multicenter observational study of the DyeVert™ plus contrast reduction system

Contrast induced‐acute kidney injury following peripheral angiography with carbon dioxide versus iodinated contrast media: A meta‐analysis and systematic review of current literature

Post-Hoc Study: Intravenous Hydration Treatment in Chinese Patients with High Risk of Contrast-Induced Nephropathy Following Percutaneous Coronary Intervention

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