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Predictors of outcomes of contrast-induced acute kidney injury after percutaneous coronary intervention in patients with chronic kidney disease.
Am J Cardiol 2014; 114(12):1830-5AJ

Abstract

Contrast-induced acute kidney injury (CI-AKI) is a serious complication that is difficult to predict in patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI). The aim of this study was to investigate predictors and clinical outcomes of CI-AKI in patients with CKD after PCI. A total of 297 patients with CKD who underwent PCI from September 2006 to December 2011 were enrolled. CI-AKI was defined as serum creatinine level either ≥25% or ≥0.5 mg/dl from baseline within 72 hours after PCI. The primary outcome was all-cause death. The median follow-up duration was 26 months (interquartile range 12 to 40), and CI-AKI occurred in 55 patients (19%). In multivariate logistic regression analyses, the development of CI-AKI was associated with female gender, left ventricular systolic dysfunction, acute myocardial infarction, PCI for left main disease, serum hemoglobin level, and a contrast volume to creatinine clearance ratio >6.0. The development of CI-AKI was significantly associated with increased in-hospital mortality (18.2% vs 3.7%, p = 0.001). Cox proportional-hazard analysis showed that the incidence of all-cause death was significantly higher in patients who developed CI-AKI than in those without CI-AKI (41.8% vs 16.1%, adjusted hazard ratio 3.0, 95% confidence interval 1.6 to 5.6, p <0.001). In conclusion, female gender, left ventricular systolic dysfunction, acute myocardial infarction, PCI for left main disease, serum hemoglobin level, and contrast volume to creatinine clearance ratio >6.0 are independent predictors of CI-AKI. The development of CI-AKI is significantly associated with increased in-hospital and long-term adverse clinical outcomes in patients with CKD undergoing PCI.

Authors+Show Affiliations

Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: sh1214.choi@samsung.com.Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25438909

Citation

Kim, Ji-Hwan, et al. "Predictors of Outcomes of Contrast-induced Acute Kidney Injury After Percutaneous Coronary Intervention in Patients With Chronic Kidney Disease." The American Journal of Cardiology, vol. 114, no. 12, 2014, pp. 1830-5.
Kim JH, Yang JH, Choi SH, et al. Predictors of outcomes of contrast-induced acute kidney injury after percutaneous coronary intervention in patients with chronic kidney disease. Am J Cardiol. 2014;114(12):1830-5.
Kim, J. H., Yang, J. H., Choi, S. H., Song, Y. B., Hahn, J. Y., Choi, J. H., ... Gwon, H. C. (2014). Predictors of outcomes of contrast-induced acute kidney injury after percutaneous coronary intervention in patients with chronic kidney disease. The American Journal of Cardiology, 114(12), pp. 1830-5. doi:10.1016/j.amjcard.2014.09.022.
Kim JH, et al. Predictors of Outcomes of Contrast-induced Acute Kidney Injury After Percutaneous Coronary Intervention in Patients With Chronic Kidney Disease. Am J Cardiol. 2014 Dec 15;114(12):1830-5. PubMed PMID: 25438909.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of outcomes of contrast-induced acute kidney injury after percutaneous coronary intervention in patients with chronic kidney disease. AU - Kim,Ji-Hwan, AU - Yang,Jeong Hoon, AU - Choi,Seung-Hyuk, AU - Song,Young Bin, AU - Hahn,Joo-Yong, AU - Choi,Jin-Ho, AU - Lee,Sang Hoon, AU - Gwon,Hyeon-Cheol, Y1 - 2014/09/28/ PY - 2014/06/09/received PY - 2014/09/14/revised PY - 2014/09/14/accepted PY - 2014/12/3/entrez PY - 2014/12/3/pubmed PY - 2015/3/4/medline SP - 1830 EP - 5 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 114 IS - 12 N2 - Contrast-induced acute kidney injury (CI-AKI) is a serious complication that is difficult to predict in patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI). The aim of this study was to investigate predictors and clinical outcomes of CI-AKI in patients with CKD after PCI. A total of 297 patients with CKD who underwent PCI from September 2006 to December 2011 were enrolled. CI-AKI was defined as serum creatinine level either ≥25% or ≥0.5 mg/dl from baseline within 72 hours after PCI. The primary outcome was all-cause death. The median follow-up duration was 26 months (interquartile range 12 to 40), and CI-AKI occurred in 55 patients (19%). In multivariate logistic regression analyses, the development of CI-AKI was associated with female gender, left ventricular systolic dysfunction, acute myocardial infarction, PCI for left main disease, serum hemoglobin level, and a contrast volume to creatinine clearance ratio >6.0. The development of CI-AKI was significantly associated with increased in-hospital mortality (18.2% vs 3.7%, p = 0.001). Cox proportional-hazard analysis showed that the incidence of all-cause death was significantly higher in patients who developed CI-AKI than in those without CI-AKI (41.8% vs 16.1%, adjusted hazard ratio 3.0, 95% confidence interval 1.6 to 5.6, p <0.001). In conclusion, female gender, left ventricular systolic dysfunction, acute myocardial infarction, PCI for left main disease, serum hemoglobin level, and contrast volume to creatinine clearance ratio >6.0 are independent predictors of CI-AKI. The development of CI-AKI is significantly associated with increased in-hospital and long-term adverse clinical outcomes in patients with CKD undergoing PCI. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/25438909/Predictors_of_outcomes_of_contrast_induced_acute_kidney_injury_after_percutaneous_coronary_intervention_in_patients_with_chronic_kidney_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(14)01850-5 DB - PRIME DP - Unbound Medicine ER -