Contrast-Induced Nephropathy and Long-Term Mortality After Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

Sun, Guoli; Chen, Pengyuan; Wang, Kun; Li, Hualong; Chen, Shiqun; Liu, Jin; He, Yibo; Song, Feier; Liu, Yong; Chen, Jiyan

doi:10.1177/0003319718803677

Cited by 62 publications

(58 citation statements)

References 32 publications

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“…CIN is the one of the most common causes of hospital-acquired kidney injury due to the growing number of contrast-enhanced imaging studies, including PCI. It is known to raise morbidity and mortality and increase healthcare costs, as well as prolong hospitalization [20, 21]. The incidence of CIN was 3.3% in the interventional cardiology registry from Mayo Clinic including 7586 patients [22].…”

Section: Discussionmentioning

confidence: 99%

Fibrinogen-to-Albumin Ratio Predicts Contrast-Induced Nephropathy in Patients after Emergency Percutaneous Coronary Intervention

You

Guo

Lin

et al. 2019

Cardiology Research and Practice

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Background The aim of the present study was to investigate the association between fibrinogen-to-albumin ratio (FAR) with contrast-induced nephropathy (CIN) in patients undergoing emergency percutaneous coronary intervention (PCI). Methods 565 patients with emergency PCI were consecutively enrolled. The primary outcome was CIN defined as either a 25% increase in baseline serum creatinine levels or a 0.5 mg/dL (44 μmol/L) increase in absolute serum creatinine levels within 72 h after the contrast medium exposure. Logistic regression analysis was applied to analyze whether FAR was an independent risk factor for CIN. Results Overall, 29 (5.1%) patients developed CIN. Compared with the patients without CIN, the patients developing CIN had lower albumin (39.79 ± 3.95 vs. 37.14 ± 5.21, P=0.012) and higher fibrinogen levels (3.51 ± 0.94 vs. 4.14 ± 0.96, P < 0.001). In the multivariate logistic analysis, FAR was an independent predictor of CIN (OR = 3.97; 95% CI, 1.61–9.80; P=0.003) along with perihypotension, age >75 years, and LVEF <45%, and 0.106 was the optimal cutoff value of preprocedural FAR to predict CIN. Conclusion Preprocedural levels of FAR were associated with CIN in patients after emergency PCI.

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Section: Discussionmentioning

confidence: 99%

Fibrinogen-to-Albumin Ratio Predicts Contrast-Induced Nephropathy in Patients after Emergency Percutaneous Coronary Intervention

You

Guo

Lin

et al. 2019

Cardiology Research and Practice

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“…With the wide use of contrast media (CM), contrast-induced nephropathy (CIN) has become an important cause of hospital-acquired kidney injury, which accounts for increase in morbidity, in-hospital stays, and mortality. [1][2][3][4][5] CIN is defined as an absolute rise in the serum creatinine (Scr) level by at least 44 μmol/l (0.5 mg/dl) or an increase in Scr level of >25% over baseline within 3 days following intravascular CM exposure. 6 The incidence of CIN has been reported to be <2% in general population, but it can rise up to 20% or more in high-risk groups such as the elderly patients and patients with diabetes mellitus (DM) or chronic kidney disease (CKD).…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of effect of renin–angiotensin–aldosterone system blockers on contrast-induced nephropathy

Wang

Sun

et al. 2020

J Renin Angiotensin Aldosterone Syst

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Background: The purpose of this study was to systematically evaluate the effect of renin–angiotensin–aldosterone system blockers on the incidence of contrast-induced nephropathy in patients undergoing coronary angiography or percutaneous coronary intervention. Methods: A systematic literature search of several databases was conducted to identify studies that met the inclusion criteria. A total of 12 studies with 14 trials that performed studies on a total of 4864 patients (2484 treated with renin–angiotensin–aldosterone system blockers and 2380 in the control group) were included. The primary endpoint was the overall incidence of contrast-induced nephropathy. Analyses were performed with STATA version 12.0. Results: The overall contrast-induced nephropathy incidence in renin–angiotensin–aldosterone system blocker and control groups was 10.43% and 6.81%, respectively. The pooled relative risk of contrast-induced nephropathy incidence was 1.22 (95% confidence interval: 0.81–1.84) in the renin–angiotensin–aldosterone system blocker group. An increased risk of developing contrast-induced nephropathy in the renin–angiotensin–aldosterone system blocker group was observed among older people, non-Asians, chronic users, and studies with larger sample size, and the pooled RRs and 95% confidence intervals were 2.02 (1.21–3.36), 2.30 (1.41–3.76), 1.69 (1.10–2.59) and 1.83 (1.28–2.63), respectively. Conclusions: Intervention with renin–angiotensin–aldosterone system blockers was associated with an increased risk of contrast-induced nephropathy among non-Asians, chronic users, older people, and studies with larger sample size. Large clinical trials with strict inclusion criteria are needed to confirm our results and to evaluate the effect further.

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“…Contrast-associated acute kidney injury (CA-AKI) is one of the major complications that occurs after contrast exposure [1] and is signi cantly associated with higher mortality and worsened clinical outcomes [2]. Guidelines recommend that patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) should be assessed for the risk of CA-AKI [3].…”

Section: Trial Registration Number Nct01400295 Backgroundmentioning

confidence: 99%

A prediction model of Contrast-associated Acute Kidney Injury in Patients with Hypoalbuminemia Undergoing Coronary Angiography

Liu

Liu²,

Li³

et al. 2020

Preprint

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Background: Risk stratification is recommended as the key step to prevent contrast-associated acute kidney injury (CA-AKI) by allowing for prevention among at-risk patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Patients with hypoalbuminemia are prone to CA-AKI and do not have their own risk stratification tool. Therefore, we developed and validated a model for predicting CA-AKI in patients with hypoalbuminemia undergoing CAG/PCI.Methods: A total of 1272 consecutive patients with hypoalbuminemia undergoing CAG/PCI were enrolled and randomly assigned (2:1 ratio) to a development cohort (n = 848) and a validation cohort (n = 424). CA-AKI was defined as a serum creatinine (SCr) increase of ≥ 0.3 mg/dL or 50% from baseline within the first 48 to 72 hours following CAG/PCI. A prediction model was established with independent predictors according to multivariate logistic regression and a stepwise approach, showing as a nomogram. The discrimination of the nomogram was assessed by the area under the receiver operating characteristic (ROC) curve and was compared to the classic Mehran CA-AKI score. Calibration was assessed using the Hosmer–Lemeshow test.Results: Overall, 8.4% (71/848) of patients in the development cohort and 11.2% (48/424) of patients in the validation cohort experienced CA-AKI. The simple nomogram included estimated glomerular filtration rate (eGFR), serum albumin (ALB), age and the use of intra-aortic balloon pump (IABP); showed better predictive ability than the Mehran score (C-index 0.756 vs. 0.693, p = 0.02); and had good calibration (Hosmer–Lemeshow test p = 0.187). Conclusions: Our data suggested that the simple model might be a good tool for predicting CA-AKI in high-risk patients with hypoalbuminemia undergoing CAG/PCI, but our findings require further external validation.Trial registration number NCT01400295

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Contrast-Induced Nephropathy and Long-Term Mortality After Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

Cited by 62 publications

References 32 publications

Fibrinogen-to-Albumin Ratio Predicts Contrast-Induced Nephropathy in Patients after Emergency Percutaneous Coronary Intervention

Fibrinogen-to-Albumin Ratio Predicts Contrast-Induced Nephropathy in Patients after Emergency Percutaneous Coronary Intervention

Meta-analysis of effect of renin–angiotensin–aldosterone system blockers on contrast-induced nephropathy

A prediction model of Contrast-associated Acute Kidney Injury in Patients with Hypoalbuminemia Undergoing Coronary Angiography

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