Short-Term Rosuvastatin Therapy for Prevention of Contrast-Induced Acute Kidney Injury in Patients With Diabetes and Chronic Kidney Disease

Han, Yaling; Zhu, Guoying; Li, Han; Hou, Fengxia; Huang, Weijian; Liu, Huiliang; Gan, Jihong; Jiang, Tiemin; Li, Xiaoyan; Wang, Wei; Ding, Shilei; Jia, Shanshan; Shi, Weifeng; Wang, Dongmei; Sun, Ling; Qiu, Jian; Wang, Xiaozeng; Li, Yi; Deng, Jie; Li, Jing; Xu, Kai; Xu, Bo; Mehran, Roxana; Huo, Yong

doi:10.1016/j.jacc.2013.09.017

Cited by 193 publications

(165 citation statements)

References 40 publications

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“…Although it remains uncertain whether statins lower the risk of contrast-induced AKI or are associated with AKI when used in high doses, they have been consistently shown to lower major adverse cardiovascular events in most populations (37)(38)(39)(40)(41)(42)(43)(44)(45). To our knowledge, there are no published reports of AKI associated with b-blocker use.…”

Section: Discussionmentioning

confidence: 99%

Contrast-Associated AKI and Use of Cardiovascular Medications after Acute Coronary Syndrome

Leung¹,

Pannu

Tan

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives AKI after coronary angiography is associated with poor long-term outcomes. The relationship between contrast-associated AKI and subsequent use of prognosis-modifying cardiovascular medications is unknown.Design, setting, participants, & measurements A cohort study of 5911 participants 66 years of age or older with acute coronary syndrome who received a coronary angiogram in Alberta, Canada was performed between November 1, 2002, and November 30, 2008. AKI was identified according to Kidney Disease Improving Global Outcomes AKI criteria.Results In multivariable logistic regression models, compared with participants without AKI, those with stages 1 and 2-3 AKI had lower odds of subsequent use of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker within 120 days of hospital discharge (adjusted odds ratio, 0.65; 95% confidence interval, 0.53 to 0.80 and odds ratio, 0.34; 95% confidence interval, 0.23 to 0.48, respectively). Subsequent statin and b-blockers use within 120 days of hospital discharge was significantly lower among those with stages 2-3 AKI (adjusted odds ratio, 0.44; 95% confidence interval, 0.31 to 0.64 and odds ratio, 0.46; 95% confidence interval, 0.31 to 0.66, respectively). These associations were consistently seen in patients with diabetes mellitus, heart failure, low baseline eGFR, and albuminuria; 952 participants died during subsequent follow-up after hospital discharge (mean=3.1 years). The use of each class of cardiovascular medication was associated with lower mortality, including among those who had experienced AKI.Conclusions Strategies to optimize the use of cardiac medications in people with AKI after coronary angiography might improve care.

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Section: Discussionmentioning

confidence: 99%

Contrast-Associated AKI and Use of Cardiovascular Medications after Acute Coronary Syndrome

Leung¹,

Pannu

Tan

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…Cao S et al found that atorvastatin prevents the development of oxidative stress, which leads to the prevention of CIN (58,59) . In addition, Han et al have shown that rosuvastatin prevents the development of CIN in patients with diabetes and chronic kidney disease (60) . Current studies have provided additional data on atorvastatin.…”

Section: Protective Effects Of Statins Against Contrast-induced Nephrmentioning

confidence: 99%

Beyond the Lipid-lowering Effects of Statins: Renal Effects

Kaya¹,

Kaya²,

Bekataş³

2017

Kosuyolu Heart Journal

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Nowadays statins, 3 hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase enzyme inhibitors, are used in the treatment of hyperlipidemia. Statins have been shown to decrease cardiovascular mortality and morbidity in both coronary artery disease and peripheral arterial disease. Besides their lipid-lowering effects, statins have pleiotropic effects such as improvement of endothelial dysfunction, atherosclerotic plaques stabilization, oxidative stress inhibition, anti-inflammatory, and antithrombogenic effects. Some clinical trials have revealed that statin therapy improved renal function. On the other hand, statins have been shown to have no beneficial effects in many studies in renal function. In this review, we aimed to evaluate the effects of statins on renal function.Key Words: Statin; chronic renal disease; acute renal disease; contrast-induced nephropathy Statinlerin Lipit Düşürücü Etkilerinin Ötesi: Renal Etkileri ÖZETStatin 3-hidroksi-3-metilglutaril CoA (HMG CoA) redüktaz enzim inhibitörü olarak günümüzde hiperlipidemi tedavisinde yaygın olarak kullanılmaktadır. Özellikle koroner arter hastalığı ve periferik arter hastalığında morbidite ve mortaliteyi azalttığı gösterilmiştir. Aynı zamanda aterosklerotik plak stabilizasyonu, endotel fonksiyonunu iyileştirme, oksidatif stres, inflamasyon ve tromboza yanıtın inhibisyonu gibi pleiotropik etkileri de bulunmaktadır. Statinin kanıtlanmış birçok yararlı etkisinin olmasının yanında, özellikle böbrek fonksiyonları üzerine etkisiyle ilgili çalışmalarda çelişkili sonuçlar bulunmaktadır. Bazı klinik çalışmalarda statinin böbrek fonksiyonları üzerine faydalı olduğu saptanmışken, birçok çalışmada da faydalı etkisinin olmadığı gösterilmiştir. Biz bu derlemede statin ile akut, kronik ve kontrasta bağlı nefropati ilişkilerini araştıran çalışmaları inceleyerek, statinin böbrek fonksiyonları üzerine etkisini değerlendirmeye çalıştık.

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“…The TRACK-D trial design has been previously described in detail (11). In brief, this investigator-initiated, prospective, randomized, controlled trial enrolled patients with type 2 diabetes and stage 2 or 3 CKD undergoing coronary/peripheral arterial diagnostic angiography, left ventriculography, or percutaneous coronary intervention (PCI) in 53 Chinese centers.…”

Section: Study Populationmentioning

confidence: 99%

“…In the multicenter, randomized TRACK-D study, we reported that periprocedural use of rosuvastatin effectively reduced the risk of CIAKI in patients with diabetes and CKD undergoing coronary/peripheral arterial angiography and percutaneous intervention (11). The benefit of rosuvastatin therapy, regarding CIAKI, was consistently effective among various subgroups, including gender.…”

Section: Introductionmentioning

confidence: 96%

Short-term rosuvastatin therapy prevents contrast-induced acute kidney injury in female patients with diabetes and chronic kidney disease: a subgroup analysis of the TRACK-D study

Li¹,

Li²,

Xu³

et al. 2016

J. Thorac. Dis.

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Background: Female patients are at higher risk of contrast-induced acute kidney injury (CIAKI) compared to males. In the multicenter, prospective, TRACK-D study, short-term rosuvastatin has proven effectively reduce CIAKI in patients with type 2 diabetes mellitus and stage 2-3 chronic kidney disease (CKD). This study aimed to explore the efficacy of rosuvastatin in the female TRACK-D population.Methods: This study was a gender-based analysis of 2,998 patients (1,044 females) enrolled in the TRACK-D study and were randomized to short-term (2 days before and 3 days after procedure) rosuvastatin therapy or standard of care. The primary outcome was the incidence of CIAKI and the secondary outcome was a composite of death, dialysis/hemofiltration or worsening heart failure at 30 days.Results: CIAKI incidence was comparable between male and female patients in the overall study population (2.5% vs. 3.4%, P=0.165) and in the rosuvastatin group (2.4% vs. 2.1%, P=0.72), while it was higher in females than in males in the control group (3.1% vs. 5.3%, P=0.04). Female gender was an independent risk factor of CIAKI [odds ratio (OR) =1.65; 95% confidence interval (CI), 1.03-2.63; P=0.036].Rosuvastatin treatment vs. control lowered CIAKI rate in females [2.1% vs. 5.3%; relative risk (RR) =0.39; 95% CI, 0.19-0.77; number needed to treat (NNT) =31], particularly among those with CKD stage 2 (1.2% vs. 4.1%, P=0.011). Secondary outcome incidence was similar for females in the rosuvastatin and control groups (3.7% vs. 4.9%, P=0.37). Conclusions: Compared to males, untreated females with diabetes mellitus and CKD had a higher risk of CIAKI, which can be reduced by short-term rosuvastatin treatment.

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Short-Term Rosuvastatin Therapy for Prevention of Contrast-Induced Acute Kidney Injury in Patients With Diabetes and Chronic Kidney Disease

Abstract: Rosuvastatin significantly reduced the risk of CI-AKI in patients with DM and CKD undergoing arterial contrast medium injection. (Rosuvastatin Prevent Contrast Induced Acute Kidney Injury in Patients With Diabetes [TRACK-D]; NCT00786136).

Cited by 193 publications

References 40 publications

Contrast-Associated AKI and Use of Cardiovascular Medications after Acute Coronary Syndrome

Contrast-Associated AKI and Use of Cardiovascular Medications after Acute Coronary Syndrome

Beyond the Lipid-lowering Effects of Statins: Renal Effects

Short-term rosuvastatin therapy prevents contrast-induced acute kidney injury in female patients with diabetes and chronic kidney disease: a subgroup analysis of the TRACK-D study

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