Uric acid levels and the risk of Contrast Induced Nephropathy in patients undergoing coronary angiography or PCI

Barbieri, Lucia; Verdoia, Monica; Schaffer, Alon; Cassetti, Ettore; Marino, Paolo; Suryapranata, Harry; Luca, Giuseppe De

doi:10.1016/j.numecd.2014.08.008

Cited by 42 publications

(40 citation statements)

References 30 publications

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“…Advanced age, diabetes, dehydration, hypotension, sepsis, cardiovascular disease, underlying acute kidney injury, chronic kidney disease, and concomitant use of nephrotoxic drugs were identified as well-known risk factors for CI-AKI 3,21 . In previous studies 5, 6 , we reported that hyperuricemia was an independent risk factor for CI-AKI in PCI patients, which was consistent with other studies [7][8][9][10][11][12] .…”

Section: Discussionsupporting

confidence: 91%

The relationship between Hyperuricemia and Contrast-induced acute kidney injury undergoing primary percutaneous coronary intervention: the protocol of secondary analysis for ATTEMPT RESCIND-1 study

Guo

Song

Chen

et al. 2019

Preprint

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Background Contrast-induced acute kidney injury (CI-AKI) contributes toward unfavorable clinical outcomes after primary percutaneous coronary intervention (pPCI). We assessed whether hyperuricemia is an independent predictor of CI-AKI and outcomes in patients undergoing pPCI. Methods/design Our study was a secondary analysis for the database from ATTEMPT study, enrolling 560 ST-segment elevation myocardial infarction (STEMI) patients undergoing pPCI. Eligible patients received peri-procedural either via aggressive (left ventricular end-diastolic pressure guided) or routine (<=500ml) intravenous hydration with the isotonic solution (0.9% NaCl) with randomization. The primary endpoint was CI-AKI, defined as >25% or 0.5 mg/dL increase in serum creatinine from baseline during the first 48-72 hours post-procedurally. Patients were divided into 2 groups according to the admission serum uric acid (SUA) level. Hyperuricemia was defined as a SUA level >7 mg/dL (417 mmol/L) in males and >6 mg/dL (357 mmol/L) in females. Multivariate analyses for CI-AKI and long-term mortality were performed using the logistic regression and Cox regression analyses, respectively. Discussion This study will determine the predictive value of hyperuricemia for the development of CI-AKI and outcomes in patients with STEMI undergoing pPCI. We predict that hyperuricemia will be associated with a risk of CI-AKI in patients with pPCI. Furthermore, after adjusting for other variables, long-term mortality after pPCI was higher in those with hyperuricemia than in those with normouricemia. Results of this study may provide scientific evidence for the effect of hyperuricemia on CI-AKI and long-term outcomes, thereby offering the potential possibility of lowering SUA on the development of CI-AKI and outcomes.

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Section: Discussionsupporting

confidence: 91%

The relationship between Hyperuricemia and Contrast-induced acute kidney injury undergoing primary percutaneous coronary intervention: the protocol of secondary analysis for ATTEMPT RESCIND-1 study

Guo

Song

Chen

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Advanced age, diabetes, dehydration, hypotension, sepsis, cardiovascular disease, underlying acute kidney injury, chronic kidney disease, and concomitant use of nephrotoxic drugs were identified as well-known risk factors for CI-AKI [3,21]. In previous studies [5,6], we reported that hyperuricemia was an independent risk factor for CI-AKI in PCI patients, which was consistent with other studies [7][8][9][10][11][12]. However, other studies did not show the same conclusion [13,14] [17].…”

Section: Discussionsupporting

confidence: 84%

“…In previous studies, we reported that hyperuricemia was an independent risk factor for CI-AKI after PCI [5,6]. However, the conclusion remains controversial [7][8][9][10][11][12][13][14]. In addition, only a limited number of studies reported that hyperuricemia was an independent predictor of CI-AKI in STEMI patients undergoing pPCI.…”

Section: Introductionmentioning

confidence: 97%

The relationship between Hyperuricemia and Contrast-induced acute kidney injury undergoing primary percutaneous coronary intervention: the protocol of secondary analysis for ATTEMPT RESCIND-1 study

Guo

Song

Chen

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Contrast-induced acute kidney injury (CI-AKI) contributes toward unfavorable clinical outcomes after primary percutaneous coronary intervention (pPCI). We assessed whether hyperuricemia is an independent predictor of CI-AKI and outcomes in patients undergoing pPCI. Methods/design: Our study was a secondary analysis for the database from ATTEMPT study, enrolling 560 ST-segment elevation myocardial infarction (STEMI) patients undergoing pPCI. Eligible patients received peri-procedural either via aggressive (left ventricular end-diastolic pressure guided) or routine (<=500ml) intravenous hydration with the isotonic solution (0.9% NaCl) with randomization. The primary endpoint was CI-AKI, defined as >25% or 0.5 mg/dL increase in serum creatinine from baseline during the first 48-72 hours post-procedurally. Patients were divided into 2 groups according to the admission serum uric acid (SUA) level. Hyperuricemia was defined as a SUA level >7 mg/dL (417 mmol/L) in males and >6 mg/dL (357 mmol/L) in females. Multivariate analyses for CI-AKI and long-term mortality were performed using the logistic regression and Cox regression analyses, respectively. Discussion: This study will determine the predictive value of hyperuricemia for the development of CI-AKI and outcomes in patients with STEMI undergoing pPCI. We predict that hyperuricemia will be associated with a risk of CI-AKI in patients with pPCI. Furthermore, after adjusting for other variables, long-term mortality after pPCI was higher in those with hyperuricemia than in those with normouricemia. Results of this study may provide scientific evidence for the effect of hyperuricemia on CI-AKI and long-term outcomes, thereby offering the potential possibility of lowering SUA on the development of CI-AKI and outcomes.

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“…Serum UA level has a strong association with the severity of coronary artery disease and an increase in UA levels is a marker of poor prognosis (3). Again, it has been demonstrated in an extensive study that UA levels could also be associated with the development of contrastinduced nephropathy after PCI (18). However, although the relationship between serum UA levels and cardiovascular risk are well established, the effect of increases in UA levels on MACE development or risk score are not clearly demonstrated.…”

Section: Discussionmentioning

confidence: 99%

Elevated serum uric acid levels are associated with increased risk score and mace development in patients with stemi

Aksu¹,

Gülcü²

2019

Ann Med Res

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Aim: Although the relationship between changes in serum uric acid (UA) levels and adverse events in ST segment elevation myocardial infarction (STEMI) patients is well known, the effect of an increase in UA levels on risk scores or major adverse cardiovascular event (MACE) development are not well established. In this study, we investigated the effects of ordinal changes in serum UA levels on adverse events and risk scores in STEMI patients. Material and Methods: The patients presenting with a diagnosis of STEMI and undergoing coronary angiography were included in the study. The patients were divided into seven groups evenly according to baseline UA levels and the effects of changes in UA levels on risk score and MACE were investigated. Results: A total 1200 STEMI patients was included in the study. The mean age of the patients was 62 years and 72% of them were males. While both Syntax score-II (SS-2) and Cadillac scores (CS) were lower among Group-1 and Group-4; SS-2, CS and development of MACE were markedly increased with an increase in UA levels. Conclusions: The UA levels in STEMI patients can be guiding for the clinician regarding the development of adverse event and patient-based intensive approaches should be considered in the patients with higher UA levels.

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Uric acid levels and the risk of Contrast Induced Nephropathy in patients undergoing coronary angiography or PCI

Cited by 42 publications

References 30 publications

The relationship between Hyperuricemia and Contrast-induced acute kidney injury undergoing primary percutaneous coronary intervention: the protocol of secondary analysis for ATTEMPT RESCIND-1 study

The relationship between Hyperuricemia and Contrast-induced acute kidney injury undergoing primary percutaneous coronary intervention: the protocol of secondary analysis for ATTEMPT RESCIND-1 study

The relationship between Hyperuricemia and Contrast-induced acute kidney injury undergoing primary percutaneous coronary intervention: the protocol of secondary analysis for ATTEMPT RESCIND-1 study

Elevated serum uric acid levels are associated with increased risk score and mace development in patients with stemi

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