Impact of Rosuvastatin on Contrast-Induced Acute Kidney Injury in Patients at High Risk for Nephropathy Undergoing Elective Angiography

Abacı, Okay; Özkan, Alev Arat; Kocas, Cuneyt; Çetinkal, Gökhan; Karaca, Osman Sukru; Baydar, Onur; Kaya, Ayşem; Gürmen, Tevfik

doi:10.1016/j.amjcard.2015.01.007

Cited by 28 publications

(34 citation statements)

References 18 publications

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“…The mean baseline SCr ranged from 64.90 ± 14.83 umol/L to 1.4 ± 0.5 mg/dL. All trials evaluated patients undergoing CAG or PCI, including 9 articles [7,9,10,13–17,21] which exclusively enrolled the patients undergoing PCI and 3 articles [12,18,20] which exclusively enrolled the patients undergoing CAG. The criteria used to define CIN were similar among the individual studies.…”

Section: Resultsmentioning

confidence: 99%

“…And 2 trials [11,15] only assessed patients with DM. One trial [18] exclusively evaluated patients with CKD which was defined eGFR <60 mL/min/1.73 m 2 , and 2 trials [19,21] enrolled CKD patients defined as creatinine clearance rate <60 mL/min, and 1 trial [8] enrolled patients with eGFR>60 mL/min/1.73 m 2 , and 1 trial [11] enrolled patients with 60 mLmin/1.73 m 2 ≤ eGFR ≤90 mL/min/1.73 m 2 , and 6 trials [7,12–15,17] excluded patients with severe renal insufficiency, and 4 trials [9,10,16,20] did not record precise renal function.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of short-term moderate or high-dose rosuvastatin in preventing contrast-induced nephropathy

Liang

Yang²,

Fu³

2017

Medicine

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Background:The prophylactic efficacy of statin pretreatment for the prevention of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) remains controversial. The aim of the study was to perform a meta-analysis of randomized controlled trials (RCTs) to assess the effectiveness of short-term moderate or high-dose rosuvastatin pretreatment in preventing CIN.Methods:We included RCTs comparing short-term moderate or high-dose rosuvastatin treatment versus low-dose rosuvastatin treatment or placebo for preventing CIN. The primary endpoint was the incidence of CIN within 2 to 5 days after contrast administration, and related-parameters including serum creatinine (SCr), cystatin C (CysC), hypersensitive C-reactive protein (hs-CRP), urine microalbumin (mALB) were also extracted.Results:Fifteen RCTs with a total of 2673 patients were identified and analyzed. Patients who received moderate or high-dose rosuvastatin pretreatment had a 55% lower risk of CIN compared with low-dose rosuvastatin pretreatment or placebo group based on a fixed effect model (RR = 0.45, 95% CI 0.35–0.58, P < .0001). The benefit of moderate or high-dose rosuvastatin was consistent in both comparisons with low-dose rosuvastatin (RR = 0.40, 95% CI 0.27–0.59, P < .0001) or placebo (RR = 0.45, 95% CI 0.35–0.58, P < .0001). And moderate (20 mg) or high dose (≥40 mg) rosuvastatin significantly reduced the incidence of CIN compared with the control (RR = 0.39, 95% CI 0.29–0.54, P < .0001, RR = 0.56, 95% CI 0.37–0.85, P = .006, respectively). Subgroup analysis showed that moderate or high-dose rosuvastatin pretreatment could decrease the incidence of CIN in patients with chronic kidney disease (CKD) (RR = 0.53, 95% CI 0.30–0.93, P = .03) or diabetes mellitus (DM) (RR = 0.51, 95% CI 0.31–0.86, P = .01) or acute coronary syndrome (ACS) patients undergoing PCI (RR = 0.52, 95% CI 0.35–0.76, P = .0009) or in studies which received mean contrast volume ≥110 mL (RR = 0.43, 95% CI 0.32–0.58, P < .0001). The SCr, CysC, hs-CRP, and mALB after the operation in the moderate or high-dose rosuvastatin group were lower than those of low-dose rosuvastatin group.Conclusion:This meta-analysis demonstrated that moderate or high-dose rosuvastatin treatment could reduce the incidence of CIN in patients undergoing CAG or PCI. Moreover, moderate or high-dose rosuvastatin would be beneficial in high-risk patients with CKD or DM or undergoing PCI.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Efficacy of short-term moderate or high-dose rosuvastatin in preventing contrast-induced nephropathy

Liang

Yang²,

Fu³

2017

Medicine

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“…In contrast, another meta-analysis by Zhang et al did not show the protective effect of short-term high-dose statins to reduce CI-AKI (11). Similarly the study by Abaci et al showed administration of rosuvastatin before coronary angiography did not reduce the risk of CI-AKI (12). Another study to evaluate the effect of short-term highdose atorvastatin to reduce the risk of CI-AKI showed glomerular filtration rate (GFR) in patients receiving atorvastatin was higher than the placebo group after coronary angiography (13).…”

Section: Introductionmentioning

confidence: 54%

Does high-dose lovastatin therapy diminish the risk of iodinated contrast induced acute kidney injury? A double-blind placebo-controlled clinical trial

Forghani¹,

Fathizade²,

Vahedi³

et al. 2018

J Renal Inj Prev

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Short-term high-dose administration of lovastatin can reduce the risk of contrast-induced acute kidney injury (CI-AKI).Please cite this paper as: Forghani Introduction:Contrast-induced acute kidney injury (CI-AKI) is one of the common causes of acute kidney injury. Various studies have been conducted to reduce the risk of CI-AKI. Objectives: In this study, we examined the effectiveness of lovastatin in preventing CI-AKI in patients who required iodinated contrast injection. Patients and Methods: This double-blind clinical trial was conducted on 122 patients scheduled for coronary angiography, abdominal computed tomography (CT) scan, and pulmonary CT angiography. Patients were randomly divided into two groups of receiving lovastatin and placebo. Estimated glomerular filtration rate (eGFR) at baseline and 48 hours after iodinated contrast injection was calculated. Results: The incidence of CI-AKI in all study population was 3.3% (1.6% in lovastatin group, and 5% in placebo group; P = 0.309). A significant difference in the mean changes of eGFR (the differences in the mean of eGFR at the 48 hours after iodinated contrast injection versus baseline) between placebo and lovastatin group was observed (P < 0.001). This finding showed that, after intervention a further decline in the mean of eGFR in the placebo group than the lovastatin group was happened. Conclusion: After iodinated contrast agent administration, in the lovastatin group mean change eGFR was significantly less than the placebo group. This finding indicated that highdose short-term lovastatin treatment may be effective on CI-AKI prevention.

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“…Recently, Abaci et al concluded that statins have no effect on the incidence of CIN in stable cases without evident inflammation. However, they reduce the incidence of CIN by an anti-inflammatory, antioxidant effect in patients with acute coronary syndromes (23) .…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Monocyte to High-Density Lipoprotein Cholesterol Ratio for Contrast-Induced Nephropathy in Patients with ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention

Zehi̇r¹

2017

Kosuyolu Heart Journal

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Introduction: Contrast-induced nephropathy (CIN) is a serious complication in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (p-PCI).The monocyte to high-density lipoprotein (HDL) cholesterol ratio (MHR) has recently been defined as an inflammation and oxidative stress marker. The aim of this study was to evaluate the predictive value of MHR for risk of CIN in patients with ST who underwent p-PCI. Patients and Methods:Data of a 2120 patients who were hospitalised with the diagnosis of STEMI and underwent p-PCI were retrospectively evaluated. A relative increase in serum creatinine levels of ≥ 25% or an absolute increase of ≥ 0.5 mg/dL from the baseline within 72 h of contrast exposure was defined as CIN. MHR was calculated on emergency admission. The risk of CIN was evaluated across MHR values. Results:The incidence of CIN was 6.6% (n= 139). Age (p= 0.001), baseline creatinine levels (p< 0.001), DM (p< 0.001), HT (p< 0.001) and anaemia (p= 0.001) were higher in patients with CIN. The patients were divided into 2 groups based on the development of CIN. Peripheral monocyte count, HDL levels and MHR did not differ between the groups. After correction for all baseline confounders, neither peripheral monocyte count nor MHR were found to be independent predictors of CIN development in our multivariate logistic regression analyses. Conclusion:Because MHR does not differ much from that in stable patients at the early phase of infarction, it cannot be a potential predictor of CIN development in patients with STEMI who underwent p-PCI.

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Impact of Rosuvastatin on Contrast-Induced Acute Kidney Injury in Patients at High Risk for Nephropathy Undergoing Elective Angiography

Cited by 28 publications

References 18 publications

Efficacy of short-term moderate or high-dose rosuvastatin in preventing contrast-induced nephropathy

Efficacy of short-term moderate or high-dose rosuvastatin in preventing contrast-induced nephropathy

Does high-dose lovastatin therapy diminish the risk of iodinated contrast induced acute kidney injury? A double-blind placebo-controlled clinical trial

Predictive Value of Monocyte to High-Density Lipoprotein Cholesterol Ratio for Contrast-Induced Nephropathy in Patients with ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention

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