Functional Contrast-Enhanced CT for Evaluation of Acute Ischemic Stroke Does Not Increase the Risk of Contrast-Induced Nephropathy
| Autor: | Michael H. Lev, R.A. Levy, David M. Greer, M. Ebril, Aneesh B. Singhal, É.C. de Camargo, Fabricio O Lima, R. Gilberto Gonzalez, Wade S. Smith, K. L. Furie, Gisele Sampaio Silva, Walter J. Koroshetz, Stuart R. Pomerantz, Hakan Ay |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Drug-Related Side Effects and Adverse Reactions media_common.quotation_subject Contrast-induced nephropathy Comorbidity Risk Assessment Article Brain Ischemia chemistry.chemical_compound symbols.namesake Iodinated contrast Risk Factors medicine Humans Contrast (vision) Radiology Nuclear Medicine and imaging cardiovascular diseases Prospective cohort study Fisher's exact test Aged media_common Creatinine business.industry Incidence Incidence (epidemiology) medicine.disease Stroke Massachusetts chemistry Acute Disease symbols Female Kidney Diseases Neurology (clinical) Radiology Tomography X-Ray Computed business Iodine |
| Zdroj: | American Journal of Neuroradiology. 31:817-821 |
| ISSN: | 1936-959X 0195-6108 |
| DOI: | 10.3174/ajnr.a1927 |
| Popis: | BACKGROUND AND PURPOSE: Concerns have recently grown regarding the safety of iodinated contrast agents used for CTA and CTP imaging. We tested whether the incidence of AN, defined by a ≥25% increase in the post−contrast scan creatinine level, was higher among patients with ischemic stroke who underwent a functional contrast-enhanced CT protocol compared with those who had no iodinated contrast administration. MATERIALS AND METHODS: The contrast-exposed group consisted of 575 patients with acute ischemic stroke who underwent CTA (n = 313), CTA/CTP (n = 224), or CTA/CTP followed by conventional angiography (n = 38) within 24 hours of stroke onset and were consecutively enrolled in a prospective cohort study. The nonexposed group consisted of 343 patients with ischemic stroke, consecutively admitted to the same institution, who did not receive iodinated contrast material. Patients were stratified by baseline eGFR. In the primary analysis, the Fisher exact test was used to compare the incidence of AN between the contrast-exposed and the nonexposed patients at 24, 48, and 72 hours and on a cumulative basis. A secondary analysis compared the incidence of AN in patients who underwent conventional angiography following CTA/CTP versus patients who underwent CTA/CTP only. RESULTS: The incidence of AN was 5% in the exposed and 10% in the nonexposed group (P = .003). Patients who underwent conventional angiography after contrast CT were at no greater risk of AN than patients who underwent CTA/CTP alone (26 patients, 5%; and 2 patients, 5%, respectively; P = .7). CONCLUSIONS: Administration of a contrast-enhanced CT protocol involving CTA/CTP and conventional angiography in selected patients does not appear to increase the incidence of CIN. |
| Databáze: | OpenAIRE |
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