Female gender and contrast-induced nephropathy in primary percutaneous intervention for ST-segment elevation myocardial infarction

Lucreziotti, Stefano; Centola, Marco; Salerno‐Uriarte, Diego; Ponticelli, G.; Battezzati, Pier Maria; Castini, Diego; Sponzilli, Carlo; Lombardi, Federico

doi:10.1016/j.ijcard.2014.03.087

Cited by 32 publications

(24 citation statements)

References 20 publications

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“…Прогностические факторы развития ИКВ-ОПП ус-ловно можно разделить на следующие группы: 1) связан-ные с пациентом (ХБП, низкая ФВ, исходный уровень СКр, терапия нефротоксичными антибиотиками, верош-пироном, петлевыми диуретиками); 2) связанные с про-цедурой ЧКВ (объем контрастного вещества, многососу-дистое поражение коронарного русла, отношение ОКВ/ СКФ), что согласуется с данными литературы [22][23][24].…”

Section: Discussionunclassified

Contrast-induced acute kidney injury after primary percutaneous coronary interventions: Prevalence, predictive factors, and outcomes

et al. 2015

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РезюмеЦель исследования. Изучить частоту, тяжесть, прогностические факторы развития и прогностическое значение индуциро-ванного контрастным веществом острого повреждения почек (ИКВ-ОПП) у пациентов с острым коронарным синдромом с подъемом сегмента ST (ОКСпST) и первичным чрескожным коронарным вмешательством (ЧКВ). Материалы и методы. У 216 пациентов, госпитализированных в городскую клиническую больницу Москвы с ОКСпST и подвергнутых первичному ЧКВ (средний возраст 64±13 лет, артериальная гипертония у 90%, инфаркт миокарда в анам-незе у 27%, хроническая болезнь почек у 7%, сахарный диабет 2-го типа у 21%), оценена частота развития ИКВ-ОПП по критериями KDIGO (2012). На основании логистического регрессионного анализа определены прогностические факторы развития ИКВ-ОПП, при телефонном опросе через 12 мес оценен прогноз. Результаты. ИКВ-ОПП диагностировано у 43 (20%) пациентов, которое представлено I (81%) и II (19%) стадиями. Паци-енты с ИКВ-ОПП были старше, характеризовались более высокими исходными уровнями креатинина в сыворотке крови, объемом контрастного вещества, отношением объем контрастного вещества/скорость клубочковой фильтрации, меньшей фракцией выброса левого желудочка. Выявлены независимые прогностические факторы развития ИКВ-ОПП: хроническая болезнь почек, многососудистое поражение коронарного русла, терапия в стационаре петлевыми диуретиками, нефро-токсичными антибиотиками, антагонистами минералокортикоидных рецепторов. Заключение. Развитие ИКВ-ОПП ассоциируется с неблагоприятными исходами: более высокой 30-дневной смертностью, более частыми повторными госпитализациями по поводу сердечно-сосудистых заболеваний.Ключевые слова: индуцированное контрастным веществом острое повреждение почек, острый коронарный синдром с подъемом сегмента ST, первичное чрескожное коронарное вмешательство. Aim. To study the incidence, severity, predictive factors, and prognostic value of contrast-induced acute kidney injury (CIAKI) in patients with ST-segment elevation acute coronary syndrome (STSEACS), who have undergone primary percutaneous coronary intervention (PCI). Subjects and methods. The 2012 KDIGO criteria were used to estimate the incidence of CIAKI in 216 patients (mean age, 64±13 years) admitted to Moscow City Clinical Hospital Sixty-Four and underwent primary PCI for STSEACS (hypertension in 90%, prior myocardial infarction in 27%, chronic kidney disease in 7%, type 2 diabetes mellitus in 21%). Logistic regression analysis was performed to identify predictive factors for CIAKI; following 12 months, its prognosis was assessed by phone. Results. Forty-three (20%) patients were diagnosed with Stages I (81%) and II (19%) CIAKI. The patients with CIAKI were older; they had higher baseline serum creatinine levels, a higher volume of contrast agent, a higher ratio of contrast medium volume to glomerular filtration rate, and lower left ventricular ejection fraction. Independent predictive factors for CIAKI were identified; these were chronic kidney disease, multivascular injury in the coronary bed, hospital therapy wi...

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Section: Discussionunclassified

Contrast-induced acute kidney injury after primary percutaneous coronary interventions: Prevalence, predictive factors, and outcomes

et al. 2015

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“…Since there were only three females, they too were excluded to make the study group homogenous as gender is known to influence the renal response to contrast injury. [19] Finally, the study cohort composed of 58 patients in DM group, and 59 patients in nondiabetic group.…”

Section: Methodsmentioning

confidence: 99%

Biomarker response to contrast administration in diabetic and nondiabetic patients following coronary angiography

Ashalatha¹,

Bitla²,

Kumar³

et al. 2017

Indian J Nephrol

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Neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C represent early renal injury markers for contrast-induced nephropathy (CIN). Baseline parameters such as type and quantity of contrast, patient preparation, renal function status, and diabetes mellitus (DM) are known to affect the response of the kidney to contrast-induced injury. This study was taken up to know the biomarker response to contrast administration in 58 diabetic and 59 nondiabetic male patients with same baseline parameters and baseline serum creatinine <1.2 mg/dl undergoing coronary angiography and their role in predicting the development of CIN. Serum creatinine, serum cystatin C, and urinary-NGAL (u-NGAL) were analyzed at baseline (0 h), 4 h, and 24 h after the administration of contrast medium. CIN was defined as a 25% increase in serum creatinine concentration from the baseline value or an absolute increase of at least 0.5 mg/dl within 48 h after the administration of contrast media. Serum creatinine rose 24 h after contrast administration in the diabetic group compared to 48 h in the nondiabetic group. Serum cystatin C levels rose 24 h after contrast administration in both the groups. The earliest marker to rise in both the groups was u-NGAL at 4 h. Diabetic patients had significantly higher u-NGAL (P = 0.005), and serum creatinine levels (P = 0.008) 4 h, and 24 h after contrast administration, respectively. Serum creatinine and u-NGAL/creatinine at 4 h were found to be the best predictors of CIN in the DM and non-DM patients, respectively. Biomarker response to contrast administration is different in diabetic and nondiabetic patients following contrast administration. Diabetic patients exhibit early and greater degree of renal impairment compared to the nondiabetic patients irrespective of the outcome. We propose the use of serum creatinine in patients with DM and u-NGAL/creatinine in non-DM patients to identify CIN as early as 4 h after contrast administration.

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“…22 We only included baseline renal function and have no information about renal function over time. This is particularly relevant since women might be at increased risk of contrast induced nephropathy 23 and consideration must be given to minimizing the use of contrast and instituting preventive measures for contrast nephropathy. Moreover, progression of CKD might be predictive of coronary and/or all-cause mortality.…”

Section: Discussionmentioning

confidence: 99%

Mild renal dysfunction and long-term adverse outcomes in women with chest pain: Results from the National Heart, Lung, and Blood Institute–sponsored Women’s Ischemia Syndrome Evaluation (WISE)

Mohandas

Segal

Srinivas

et al. 2015

American Heart Journal

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Background Chronic kidney disease (CKD) is associated with accelerated atherosclerosis and adverse cardiovascular outcomes, but mechanisms are unclear. We hypothesized that mild CKD independently predicts adverse outcomes in women with symptoms and signs of ischemia. Methods We categorized 876 women from the Women’s Ischemia Syndrome Evaluation (WISE) cohort according to estimated glomerular filtration rate (eGFR) [eGFR ≥90, normal; 60–89, mild; ≤59, severe CKD). Time to death from all-cause and cardiovascular causes and major adverse outcomes were assessed by multivariate regression adjusted for baseline covariates. Results Obstructive coronary artery disease (CAD) was present only in a minority of patients (39%). Even after adjusting for CAD severity, renal function remained a strong, independent predictor of all-cause and cardiac mortality (p<0.001). Every 10 unit decrease in eGFR was associated with a 14% increased risk of all-cause mortality [adjusted hazard ratio (AHR) 1.14 (1.08–1.20); p<0.0001], 16% increased risk of cardiovascular mortality [AHR 1.16 (1.09–1.23); p<0.0001], and 9% increased risk of adverse cardiovascular events [AHR 1.09 (1.03–1.15); p=0.002]. Conclusions Even mild CKD is a strong independent predictor of all-cause and cardiac mortality in women with symptoms/signs of ischemia, regardless of underlying obstructive CAD severity, underscoring the need to better understand the interactions between ischemic heart disease and CKD.

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Female gender and contrast-induced nephropathy in primary percutaneous intervention for ST-segment elevation myocardial infarction

Cited by 32 publications

References 20 publications

Contrast-induced acute kidney injury after primary percutaneous coronary interventions: Prevalence, predictive factors, and outcomes

Contrast-induced acute kidney injury after primary percutaneous coronary interventions: Prevalence, predictive factors, and outcomes

Biomarker response to contrast administration in diabetic and nondiabetic patients following coronary angiography

Mild renal dysfunction and long-term adverse outcomes in women with chest pain: Results from the National Heart, Lung, and Blood Institute–sponsored Women’s Ischemia Syndrome Evaluation (WISE)

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