Frequency and predictors of contrast-induced nephropathy after angioplasty for chronic total occlusions
| Autor: | Giuseppe Ferrante, Carlo Di Mario, Peter Barlis, Rohit Khurana, Francesca Del Furia, Pablo Aguiar-Souto |
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| Rok vydání: | 2010 |
| Předmět: |
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medicine.medical_specialty medicine.medical_treatment Contrast-induced nephropathy Urology Contrast Media Coronary Disease Coronary Angiography chemistry.chemical_compound Predictive Value of Tests Renal Dialysis Risk Factors Humans Medicine Angioplasty Balloon Coronary Dialysis Aged Retrospective Studies Creatinine Framingham Risk Score business.industry Incidence Percutaneous coronary intervention Retrospective cohort study Acute Kidney Injury Middle Aged medicine.disease female genital diseases and pregnancy complications Surgery Logistic Models surgical procedures operative chemistry Chronic Disease Conventional PCI Female Cardiology and Cardiovascular Medicine business Kidney disease |
| Zdroj: | International Journal of Cardiology. 139:68-74 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2008.10.006 |
| Popis: | Background The incidence and predictors of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) of chronic total occlusions (CTO) have not been specifically reported. Methods This retrospective analysis included all consecutive patients referred for PCI of CTO between April 2003 and March 2008, with baseline and 24 h postprocedural available creatinine levels. CIN was defined as 24 h postprocedural increase of baseline creatinine levels ≥0.5 mg/dl (CIN 05 ) or ≥25% (CIN 25 ). Severe renal dysfunction (SRD) was defined as acute renal failure requiring dialysis, or an increase in baseline creatinine levels ≥2.0 mg/dl (SRD 2 ) or ≥50% (SRD%). Patients were classified into risk categories for CIN, according to the validated Mehran risk score. Results A total of 227 patients were included, mean age of 64±10 years, the majority being at low risk for CIN (55% with ≤5 points in the Mehran score). CIN 25 occurred in 6.16% (14/227) patients and CIN 05 in 0.88% (2/227). The incidence of SRD 2 or SDR% was 0% (0/227) and 0.9% (2/227), respectively, with no patient requiring dialysis. Patients who developed CIN 25 received a higher contrast volume than those who did not (312 ml (210–400) vs 260 ml (200–345), p =0.14), but the difference was not statistically significant. Conclusions In this consecutive cohort of patients, the incidence of CIN following PCI for CTO was low despite the administration of moderate to large volumes of contrast media. Attempts at revascularization of CTO should not be discouraged or be prematurely interrupted because of the fear of CIN. |
| Databáze: | OpenAIRE |
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