Association Between Contrast Media Volume–Glomerular Filtration Rate Ratio and Contrast-Induced Acute Kidney Injury After Primary Percutaneous Coronary Intervention

Çelik, Ömer; Öztürk, Derya; Akın, Fatih; Ayça, Burak; Yalçın, Ahmet Arif; Ertürk, Mehmet; Bıyık, İsmail; Ayaz, Ahmet; Aktürk, İbrahim Faruk; Enhoş, Asım; Aslan, Serkan

doi:10.1177/0003319714542277

Cited by 39 publications

(27 citation statements)

References 33 publications

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“…The predictors of AKI in our propensity-matched sample were bleeding, heart failure, age ≥ 70 years, renal dysfunction on admission, and the contrast volume/GFR ratio, which is consistent with previously known data [2, 10, 20, 23, 30–32]. These data would seem to support the presumption that AKI, in terms of the access site, might be at least partially influenced by confounding factors.…”

Section: Discussionsupporting

confidence: 91%

Acute kidney injury in patients with myocardial infarction undergoing percutaneous coronary intervention using radial versus femoral access

et al. 2019

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BackgroundData on radial access (RA) as an independent risk factor for acute kidney injury (AKI) in myocardial infarction (MI) patients are conflicting. Our aim was to assess how RA influences the incidence of AKI in MI patients undergoing percutaneous coronary intervention (PCI).MethodsData from 3842 MI patients undergoing PCI at our institution from January 2011 to December 2016, of which 35.8% were performed radially, were retrospectively analyzed. A propensity-matched analysis was performed to adjust for differences in the baseline characteristics between the RA and femoral access (FA) groups. The effect of RA on the incidence of AKI was observed.ResultsIn the unmatched cohort, AKI occurred less often in the RA group [77 (5.6%) patients in the RA group compared to 250 (10.1%) patients in the FA group; p = 0.001]. After propensity-matched adjustment, the incidence of AKI was similar in the two groups.After adjustment for potential confounders, RA was not identified as an independent predictive factor for AKI in either the unmatched or the propensity-matched cohort. Bleeding, heart failure, age ≥ 70 years, renal dysfunction, and the contrast volume/GFR ratio predicted AKI in both cohorts. Additionally, diabetes, contrast volume, and hypertension were predictive of AKI in the unmatched cohort.ConclusionThe access site was not independently associated with the incidence of AKI in patients with MI in both a non-matched and a propensity-matched cohort. Our study result suggests that the lower incidence of AKI in patients treated with RA in an unmatched cohort might be substantially influenced by confounding factors, especially bleeding.Electronic supplementary materialThe online version of this article (10.1186/s12882-019-1210-8) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Acute kidney injury in patients with myocardial infarction undergoing percutaneous coronary intervention using radial versus femoral access

et al. 2019

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“…The incidence of CI-AKI after pPCI ranges from 11.9 to 17.1% according to previous studies, which is significantly higher than that of elective PCI [19][20][21][22][23]. As with above studies, our study also demonstrated a similar high incidence of 15% in this population, which is strongly associated with blood volume insufficiency, hemodynamic instability and inadequate hydration.…”

Section: Discussionsupporting

confidence: 86%

Negative association between free triiodothyronine level and contrast-induced acute kidney injury in patients undergoing primary percutaneous coronary intervention

et al. 2019

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Background: A low FT3 level is significantly associated with a variety of kidney disease and acute myocardial infarction (AMI). However, it remains unclear whether low FT3 is associated with CI-AKI in patients who underwent pPCI. Methods: Single-center retrospective study evaluated 363 STEMI patients undergoing pPCI. Patients were classfied into 2 groups, low FT3 group (FT3 < 3.1 pmol/L) and normal FT3 group (FT3 ≥ 3.1 pmol/L);CI-AKI was defined as an increase in the serum creatinine levels of ≥50% or 0.3 mg/dL above the baseline level within 48 h after contrast medium exposure. Results: Overall, 80(22.0%) patients had low FT3, and 59(16.3%) patients developed CI-AKI. The incidence of CI-AKI and in-hospital mortality was significantly higher in patients with low FT3 than normal (31.3% vs 12.0%; 15.0% vs 3.2%, respectively, both p < 0.0001). Multivariate logistic regression analysis indicated that low FT3 was an independent predictor of CI-AKI (odds ratio [OR] = 2.62, 95%CI:1.35-5.07, p < 0.05). In addition, low FT3 was associated with an increased risk of all-cause mortality during a mean follow-up period of 20 months (hazard ratio [HR] = 2.54, 95%CI:1.15-5. 60, p < 0.05). Conclusion: Low FT3 was associated with CI-AKI, short-and long-term mortality in STEMI patients after pPCI.

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“…Beside patient characteristics, procedural data and outcome characteristics were included in the multivariable regression model to elucidate the risk factors predicting AKI. As previously found, cardiogenic shock on admission, diabetes, hypertension, renal dysfunction, STEMI, heart failure [2, 5, 15, 17, 18], and contrast volume/eGFR ratio predicted AKI [5, 19]. In fact, this ratio seems to have a greater potential to discriminate between the patients who are at higher risk of AKI than the contrast volume alone since it includes 2 parameters (contrast volume and eGFR) that both predispose to AKI [19, 20].…”

Section: Discussionmentioning

confidence: 67%

Impact of KDIGO-Defined Acute Kidney Injury on Mortality after Percutaneous Coronary Intervention for Acute Myocardial Infarction

et al. 2018

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Background: There are limited data regarding the incidence and long-term impact of acute kidney injury (AKI) according to the KDIGO guidelines on the outcome in patients with myocardial infarction (MI) treated with percutaneous coronary intervention (PCI). The aim of the study was to evaluate the prevalence of AKI, as classified by the KDIGO criteria, and its association with long-term mortality. Methods: Data from 5,859 MI patients undergoing PCI at our institution were analyzed. We compared the group without and with AKI according to the KDIGO criteria in relation to long-term mortality. Results: AKI was documented in 499 (8.5%) patients. AKI stage 1 occurred in 6.2% of patients, AKI stage 2 in 0.9% of patients, and AKI stage 3 in 1.5% of patients. Patients with AKI had a higher long-term mortality (57.3 vs. 20.6%; p < 0.0001). The mortality was 50.3% in AKI stage 1, 56.9% in AKI stage 2, and 87.2% in AKI stage 3. The hazard ratios for all-cause mortality for AKI stages 1–3 were 1.77, 1.85, and 6.30 compared to patients with no AKI. Cardiogenic shock, bleeding, heart failure, age, renal dysfunction, diabetes, hyperlipidemia, ST-elevation MI, contrast volume/glomerular filtration ratio, P2Y12 receptor antagonists, and radial access were associated with the development of AKI. Conclusion: A slight increase in serum creatinine was associated with a progressive increase in long-term mortality in patients with AKI according to the KDIGO definition.

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Association Between Contrast Media Volume–Glomerular Filtration Rate Ratio and Contrast-Induced Acute Kidney Injury After Primary Percutaneous Coronary Intervention

Cited by 39 publications

References 33 publications

Acute kidney injury in patients with myocardial infarction undergoing percutaneous coronary intervention using radial versus femoral access

Acute kidney injury in patients with myocardial infarction undergoing percutaneous coronary intervention using radial versus femoral access

Negative association between free triiodothyronine level and contrast-induced acute kidney injury in patients undergoing primary percutaneous coronary intervention

Impact of KDIGO-Defined Acute Kidney Injury on Mortality after Percutaneous Coronary Intervention for Acute Myocardial Infarction

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