Early High-Dose Rosuvastatin for Contrast-Induced Nephropathy Prevention in Acute Coronary Syndrome

Leoncini, Mario; Toso, Anna; Maioli, Mauro; Tropeano, Francesco; Villani, Simona; Bellandi, Francesco

doi:10.1016/j.jacc.2013.04.105

Cited by 232 publications

(82 citation statements)

References 39 publications

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“…Leoncini et al [171] treated 252 patients with acute coronary syndrome, who were scheduled for an early invasive procedure and were at high risk for contrast-induced AKI, with high doses of rosuvastatin, that is, 40 mg on admission, followed by 20 mg/day. The incidence of AKI was significantly lower in the statin group than in controls (6.7% versus 15.1%, P = 0.003).…”

Section: Prevention Of Akimentioning

confidence: 99%

Acute Kidney Injury by Radiographic Contrast Media: Pathogenesis and Prevention

Andreucci

Faga

Pisani

et al. 2014

BioMed Research International

106

112

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It is well known that iodinated radiographic contrast media may cause kidney dysfunction, particularly in patients with preexisting renal impairment associated with diabetes. This dysfunction, when severe, will cause acute renal failure (ARF). We may define contrast-induced Acute Kidney Injury (AKI) as ARF occurring within 24–72 hrs after the intravascular injection of iodinated radiographic contrast media that cannot be attributed to other causes. The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors, including renal ischaemia, particularly in the renal medulla, the formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, and tubular epithelial and vascular endothelial injury. However, contrast-induced AKI can be prevented, but in order to do so, we need to know the risk factors. We have reviewed the risk factors for contrast-induced AKI and measures for its prevention, providing a long list of references enabling readers to deeply evaluate them both.

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Section: Prevention Of Akimentioning

confidence: 99%

Acute Kidney Injury by Radiographic Contrast Media: Pathogenesis and Prevention

Andreucci

Faga

Pisani

et al. 2014

BioMed Research International

106

112

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“…Many studies have shown the efficacy of pretreatment with statins in decreasing the risk of developing CI-AKI in patients undergoing coronary interventions [26, 27]. In a meta-analysis of 15 controlled trials, Liang et al [28] demonstrated the efficacy of pretreatment with rosuvastatin in reducing the incidence of CI-AKI in patients undergoing coronary interventions ( p < 0.05).…”

Section: Discussionmentioning

confidence: 99%

Metabolic Syndrome and the Iodine-Dose/Creatinine Clearance Ratio as Determinants of Contrast-Induced Acute Kidney Injury

et al. 2018

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Background: Finding patients at risk of developing contrast-induced acute kidney injury (CI-AKI) is important because of its associated complications. In the present study, the contribution of different variables, such as the presence of metabolic syndrome (MetS), the volume creatinine clearance (V/CrCl) ratio, the iodine-dose (I-dose)/CrCl ratio, or hypertension, to CI-AKI was evaluated. Methods: A total of 255 patients undergoing elective coronary angiography with or without intervention were enrolled and divided into a MetS and a control group. All patients were assessed for the development of CI-AKI after the procedures. Results: CI-AKI occurred in 39.23% (51 of 130) of the MetS patients and 14.4% (18 of 125) of the control group (p < 0.001). The multivariable regression model showed that male sex and the use of statins decreased the risk of CI-AKI, and high triglyceride levels, I-dose/CrCl > 0.52, MetS, CrCl ≤60 mL/min, and age ≥70 years increased the risk of CI-AKI, independent of confounding factors. The difference in the mean V/CrCl ratio was statistically significant between patients who developed CI-AKI and those who did not show renal impairment (2.36 ± 1.35 vs. 1.43 ± 0.89, respectively; p < 0.001). The ROC curve analysis of I-dose/CrCl determined the best cutoff value for patients with and those without MetS as 0.51 and 0.63, with a sensitivity value of 68 and 72% and a specificity value of 73 and 74%, respectively. Conclusions: We showed that MetS is a strong risk factor for CI-AKI in nondiabetic patients undergoing elective coronary interventions; and the I-dose/CrCl ratio is a strong predictor of CI-AKI in these patients. We suggest that clinicians identify MetS patients and calculate their I-dose/CrCl ratio before coronary interventions.

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“…Generally, the pharmacological effects of active constituents are in positive correlation with their dose within certain limits. [41][42][43] Accordingly, the score of PF1 and PF2 could reflect the quality of Dianbaizhu in some degrees. The higher factor score was, the better quality was (Fig.…”

Section: Methods Validationmentioning

confidence: 99%

A Rapid New Approach for the Quality Evaluation of the Folk Medicine <i>Dianbaizhu</i> Based on Chemometrics

Liu

Jiang

Xie

et al. 2014

CHEMICAL & PHARMACEUTICAL BULLETIN

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The analyses showed significant differences (p<0.05) in Gaultheria species but few differences (p>0.05) in their medicinal parts. G. leucocarpa var. yunnanensis appeared to the best among the Gaultheria species tested for the treatment of rheumatic diseases. Taken together, the results show that this simultaneous quantification of multiple active constituents using HPLC-DAD combined with chemometrics can be reliably applied to evaluate the quality of Dianbaizhu.

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Early High-Dose Rosuvastatin for Contrast-Induced Nephropathy Prevention in Acute Coronary Syndrome

Abstract: High-dose rosuvastatin given on admission to statin-naïve patients with ACS who are scheduled for an early invasive procedure can prevent CI-AKI and improve short-term clinical outcome. (Statin Contrast Induced Nephropathy Prevention [PRATO-ACS]; NCT01185938).

Cited by 232 publications

References 39 publications

Acute Kidney Injury by Radiographic Contrast Media: Pathogenesis and Prevention

Acute Kidney Injury by Radiographic Contrast Media: Pathogenesis and Prevention

Metabolic Syndrome and the Iodine-Dose/Creatinine Clearance Ratio as Determinants of Contrast-Induced Acute Kidney Injury

A Rapid New Approach for the Quality Evaluation of the Folk Medicine <i>Dianbaizhu</i> Based on Chemometrics

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