Contrast-induced nephropathy in urgent coronary interventions

Serafina Valente, Chiara Lazzeri, Cristina Giglioli, Massimo Margheri, Marco Comeglio, Letizia Nicolaci, Tania Chechi, Gian Franco Gensini

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Patients submitted to urgent percutaneous coronary interventions (PCIs) are quite often at high risk for contrast-induced nephropathy (CIN) since they exhibit several predisposing factors such as electrical and haemodynamic instability together with the lack of time to undergo adequate prophylaxis. This was a not blinded, non-randomized study whose aims were (i) to evaluate the incidence of CIN after urgent PCI in a high-volume cardiovascular referral practice (patients with acute myocardial infarction or with acute coronary syndromes enrolled in a single centre), and (ii) to assess the prognostic implications of CIN during hospitalization and at 1-month follow-up. METHODS: Between 1 October 2003 and 1 April 2004, 194 consecutive patients undergoing urgent coronary angiography and PCIs at our catheterization laboratory were enrolled in the study: 67 patients (34.5%) received the iso-osmolar contrast medium iodixanol (group A) and 127 patients (65.5%) received the hypo-osmolar contrast medium iopromid (group B). RESULTS: The overall incidence of CIN was 10.82%. Patients of group A showed a higher incidence of CIN than patients of group B (22.3 vs. 4.7%, P <0.05). On univariate logistic analysis, age, pre-existing renal insufficiency, intra-aortic balloon pump (an indirect indicator of haemodynamic instability), dyslipidaemia, and postprocedural hypotension were risk indicators for the development of CIN after primary PCI. On multivariate logistic analysis, age and postprocedural hypotension remained significant independent correlates of CIN. CONCLUSIONS: In emergency PCIs, CIN is a frequent complication mainly related to haemodynamic instability and pre-existing renal dysfunction. Since CIN is associated with a high in-hospital mortality rate, our data stress the need for the development and validation of new preventive strategies for renal protection during emergency PCIs.

Original languageEnglish
Pages (from-to)737-741
Number of pages5
JournalJournal of Cardiovascular Medicine
Volume7
Issue number10
DOIs
Publication statusPublished - Oct 2006

Fingerprint

Percutaneous Coronary Intervention
iopromide
Hemodynamics
Hypotension
Contrast Media
Incidence
Emergencies
Kidney
Acute Coronary Syndrome
Dyslipidemias
Hospital Mortality
Coronary Angiography
Catheterization
Causality
Renal Insufficiency
Hospitalization
Referral and Consultation
Multivariate Analysis
Myocardial Infarction
Mortality

Keywords

  • Acute coronary syndromes
  • Angioplasty
  • Contrast-induced nephropathy
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Valente, S., Lazzeri, C., Giglioli, C., Margheri, M., Comeglio, M., Nicolaci, L., ... Gensini, G. F. (2006). Contrast-induced nephropathy in urgent coronary interventions. Journal of Cardiovascular Medicine, 7(10), 737-741. https://doi.org/10.2459/01.JCM.0000247320.72783.1c

Contrast-induced nephropathy in urgent coronary interventions. / Valente, Serafina; Lazzeri, Chiara; Giglioli, Cristina; Margheri, Massimo; Comeglio, Marco; Nicolaci, Letizia; Chechi, Tania; Gensini, Gian Franco.

In: Journal of Cardiovascular Medicine, Vol. 7, No. 10, 10.2006, p. 737-741.

Research output: Contribution to journalArticle

Valente, S, Lazzeri, C, Giglioli, C, Margheri, M, Comeglio, M, Nicolaci, L, Chechi, T & Gensini, GF 2006, 'Contrast-induced nephropathy in urgent coronary interventions', Journal of Cardiovascular Medicine, vol. 7, no. 10, pp. 737-741. https://doi.org/10.2459/01.JCM.0000247320.72783.1c
Valente S, Lazzeri C, Giglioli C, Margheri M, Comeglio M, Nicolaci L et al. Contrast-induced nephropathy in urgent coronary interventions. Journal of Cardiovascular Medicine. 2006 Oct;7(10):737-741. https://doi.org/10.2459/01.JCM.0000247320.72783.1c
Valente, Serafina ; Lazzeri, Chiara ; Giglioli, Cristina ; Margheri, Massimo ; Comeglio, Marco ; Nicolaci, Letizia ; Chechi, Tania ; Gensini, Gian Franco. / Contrast-induced nephropathy in urgent coronary interventions. In: Journal of Cardiovascular Medicine. 2006 ; Vol. 7, No. 10. pp. 737-741.
@article{f420a6f5f0a3458b88ab595eb711552d,
title = "Contrast-induced nephropathy in urgent coronary interventions",
abstract = "OBJECTIVES: Patients submitted to urgent percutaneous coronary interventions (PCIs) are quite often at high risk for contrast-induced nephropathy (CIN) since they exhibit several predisposing factors such as electrical and haemodynamic instability together with the lack of time to undergo adequate prophylaxis. This was a not blinded, non-randomized study whose aims were (i) to evaluate the incidence of CIN after urgent PCI in a high-volume cardiovascular referral practice (patients with acute myocardial infarction or with acute coronary syndromes enrolled in a single centre), and (ii) to assess the prognostic implications of CIN during hospitalization and at 1-month follow-up. METHODS: Between 1 October 2003 and 1 April 2004, 194 consecutive patients undergoing urgent coronary angiography and PCIs at our catheterization laboratory were enrolled in the study: 67 patients (34.5{\%}) received the iso-osmolar contrast medium iodixanol (group A) and 127 patients (65.5{\%}) received the hypo-osmolar contrast medium iopromid (group B). RESULTS: The overall incidence of CIN was 10.82{\%}. Patients of group A showed a higher incidence of CIN than patients of group B (22.3 vs. 4.7{\%}, P <0.05). On univariate logistic analysis, age, pre-existing renal insufficiency, intra-aortic balloon pump (an indirect indicator of haemodynamic instability), dyslipidaemia, and postprocedural hypotension were risk indicators for the development of CIN after primary PCI. On multivariate logistic analysis, age and postprocedural hypotension remained significant independent correlates of CIN. CONCLUSIONS: In emergency PCIs, CIN is a frequent complication mainly related to haemodynamic instability and pre-existing renal dysfunction. Since CIN is associated with a high in-hospital mortality rate, our data stress the need for the development and validation of new preventive strategies for renal protection during emergency PCIs.",
keywords = "Acute coronary syndromes, Angioplasty, Contrast-induced nephropathy, Myocardial infarction",
author = "Serafina Valente and Chiara Lazzeri and Cristina Giglioli and Massimo Margheri and Marco Comeglio and Letizia Nicolaci and Tania Chechi and Gensini, {Gian Franco}",
year = "2006",
month = "10",
doi = "10.2459/01.JCM.0000247320.72783.1c",
language = "English",
volume = "7",
pages = "737--741",
journal = "Journal of Cardiovascular Medicine",
issn = "1558-2027",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Contrast-induced nephropathy in urgent coronary interventions

AU - Valente, Serafina

AU - Lazzeri, Chiara

AU - Giglioli, Cristina

AU - Margheri, Massimo

AU - Comeglio, Marco

AU - Nicolaci, Letizia

AU - Chechi, Tania

AU - Gensini, Gian Franco

PY - 2006/10

Y1 - 2006/10

N2 - OBJECTIVES: Patients submitted to urgent percutaneous coronary interventions (PCIs) are quite often at high risk for contrast-induced nephropathy (CIN) since they exhibit several predisposing factors such as electrical and haemodynamic instability together with the lack of time to undergo adequate prophylaxis. This was a not blinded, non-randomized study whose aims were (i) to evaluate the incidence of CIN after urgent PCI in a high-volume cardiovascular referral practice (patients with acute myocardial infarction or with acute coronary syndromes enrolled in a single centre), and (ii) to assess the prognostic implications of CIN during hospitalization and at 1-month follow-up. METHODS: Between 1 October 2003 and 1 April 2004, 194 consecutive patients undergoing urgent coronary angiography and PCIs at our catheterization laboratory were enrolled in the study: 67 patients (34.5%) received the iso-osmolar contrast medium iodixanol (group A) and 127 patients (65.5%) received the hypo-osmolar contrast medium iopromid (group B). RESULTS: The overall incidence of CIN was 10.82%. Patients of group A showed a higher incidence of CIN than patients of group B (22.3 vs. 4.7%, P <0.05). On univariate logistic analysis, age, pre-existing renal insufficiency, intra-aortic balloon pump (an indirect indicator of haemodynamic instability), dyslipidaemia, and postprocedural hypotension were risk indicators for the development of CIN after primary PCI. On multivariate logistic analysis, age and postprocedural hypotension remained significant independent correlates of CIN. CONCLUSIONS: In emergency PCIs, CIN is a frequent complication mainly related to haemodynamic instability and pre-existing renal dysfunction. Since CIN is associated with a high in-hospital mortality rate, our data stress the need for the development and validation of new preventive strategies for renal protection during emergency PCIs.

AB - OBJECTIVES: Patients submitted to urgent percutaneous coronary interventions (PCIs) are quite often at high risk for contrast-induced nephropathy (CIN) since they exhibit several predisposing factors such as electrical and haemodynamic instability together with the lack of time to undergo adequate prophylaxis. This was a not blinded, non-randomized study whose aims were (i) to evaluate the incidence of CIN after urgent PCI in a high-volume cardiovascular referral practice (patients with acute myocardial infarction or with acute coronary syndromes enrolled in a single centre), and (ii) to assess the prognostic implications of CIN during hospitalization and at 1-month follow-up. METHODS: Between 1 October 2003 and 1 April 2004, 194 consecutive patients undergoing urgent coronary angiography and PCIs at our catheterization laboratory were enrolled in the study: 67 patients (34.5%) received the iso-osmolar contrast medium iodixanol (group A) and 127 patients (65.5%) received the hypo-osmolar contrast medium iopromid (group B). RESULTS: The overall incidence of CIN was 10.82%. Patients of group A showed a higher incidence of CIN than patients of group B (22.3 vs. 4.7%, P <0.05). On univariate logistic analysis, age, pre-existing renal insufficiency, intra-aortic balloon pump (an indirect indicator of haemodynamic instability), dyslipidaemia, and postprocedural hypotension were risk indicators for the development of CIN after primary PCI. On multivariate logistic analysis, age and postprocedural hypotension remained significant independent correlates of CIN. CONCLUSIONS: In emergency PCIs, CIN is a frequent complication mainly related to haemodynamic instability and pre-existing renal dysfunction. Since CIN is associated with a high in-hospital mortality rate, our data stress the need for the development and validation of new preventive strategies for renal protection during emergency PCIs.

KW - Acute coronary syndromes

KW - Angioplasty

KW - Contrast-induced nephropathy

KW - Myocardial infarction

UR - http://www.scopus.com/inward/record.url?scp=33749014388&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33749014388&partnerID=8YFLogxK

U2 - 10.2459/01.JCM.0000247320.72783.1c

DO - 10.2459/01.JCM.0000247320.72783.1c

M3 - Article

C2 - 17001234

AN - SCOPUS:33749014388

VL - 7

SP - 737

EP - 741

JO - Journal of Cardiovascular Medicine

JF - Journal of Cardiovascular Medicine

SN - 1558-2027

IS - 10

ER -