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Guo W, Liu J, He Y, Lei L, Guo Z, Song F, Zhou Z, Liu W, Zhong X, Chen S, Rao L, Liu Y. The Impact of Contrast-Associated Acute Kidney Injury on All-Cause Mortality in Older Patients After Coronary Angiography:A 7.5-year Follow-Up. Angiology 2024; 75:434-440. [PMID: 36748250 DOI: 10.1177/00033197231155610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Older patients (≥75 years) after coronary angiography constitute an increasing proportion, but only limited data are available regarding the prognosis of geriatric contrast-associated acute kidney injury (CA-AKI). Patients (≥75 years) undergoing coronary angiography between December 2010 and September 2013 were consecutively enrolled. CA-AKI was defined as an increase in serum creatinine of 25% or .5 mg/dL from the baseline within 48-72 h of contrast exposure. All-cause mortality was assessed during median 7.5 years (interquartile range [IQR] 6.7-8.7 years) follow-up period. In total, 571 patients aged >75 years undergoing coronary angiography were enrolled in a single center study; 82 (14.4%) patients had CA-AKI. The all-cause mortality during the median 7.5 years follow-up period was 22.0% in patients with CA-AKI and 13.1% in patients without CA-AKI (P = .015). After adjusting for potential confounding factors, the multivariable analysis indicated that CA-AKI was related to an increased risk of all-cause mortality during the median 7.5-year follow-up (hazard ratio [HR]: 2.46; 95% CI: 1.29-4.7; P = .006). CA-AKI is a significant and independent predictor of long-term mortality for patients aged over 75 years who underwent coronary angiography.
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Affiliation(s)
- Wei Guo
- Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical University, China
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, China
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China
| | - Jin Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, China
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China
| | - Yibo He
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, China
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China
| | - Li Lei
- Department of Cardiology, Southern Medical University Nanfang Hospital, China
| | - Zhaodong Guo
- Department of Cardiology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Feier Song
- Department of Emergency and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China
| | - Ziyou Zhou
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China
- School of Medicine South China University of Technology, Guangzhou
| | - Wenhai Liu
- College of Pharmacy, Guangdong Medical University, China
| | - Xian Zhong
- College of Pharmacy, Guangdong Medical University, China
| | - Shiqun Chen
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Southern Medical University, Guangzhou, China
| | - Lifen Rao
- Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical University, China
| | - Yong Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, China
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China
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Shen G, He H, Zhang X, Wang L, Wang Z, Li F, Lu Y, Li W. Predictive value of systemic immune-inflammation index combined with N-terminal pro-brain natriuretic peptide for contrast-induced acute kidney injury in patients with STEMI after primary PCI. Int Urol Nephrol 2024; 56:1147-1156. [PMID: 37658947 DOI: 10.1007/s11255-023-03762-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/19/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To investigate the relationship between the incidence of contrast-induced acute kidney injury (CI-AKI) after emergency percutaneous coronary intervention (PCI) and preoperative systemic immune-inflammation index (SII) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in patients with acute ST-segment elevation myocardial infarction (STEMI), and to further analyze the predictive value of the combination of SII and NT-proBNP for CI-AKI. METHODS The clinical data of 1543 patients with STEMI who underwent emergency PCI in our hospital from February 2019 to December 2022 were retrospectively analyzed. All patients were divided into training cohort (n = 1085) and validation cohort (n = 287) according to chronological order. The training cohort was divided into CI-AKI (n = 95) and non-CI-AKI (n = 990) groups according to the 2018 European Society of Urogenital Radiology definition of CI-AKI. Multivariate Logistic regression analysis was used to determine the independent risk factors for CI-AKI. Restricted cubic spline (RCS) was used to explore the relationship between SII, NT-proBNP, and the risk of CI-AKI. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of SII, NT-proBNP, and their combination in CI-AKI. RESULTS The incidence of CI-AKI was 8.8% (95/1085). Multivariate logistic regression analysis showed that SII, NT-proBNP, age, baseline creatinine, fasting blood glucose, and diuretics were independent risk factors for CI-AKI. RCS analysis showed that SII > 1084.97 × 109/L and NT-proBNP > 296.12 pg/mL were positively associated with the incidence of CI-AKI. ROC curve analysis showed that the area under the curve of SII and NT-proBNP combined detection in predicting CI-AKI was 0.726 (95% CI 0.698-0.752, P < 0.001), the sensitivity was 60.0%, and the specificity was 77.7%, which were superior to the detection of SII or NT-proBNP alone. CONCLUSION Preprocedural high SII and NT-proBNP are independent risk factors for CI-AKI after emergency PCI in patients with STEMI. The combined detection of SII and NT-proBNP can more accurately predict CI-AKI risk than the single detection.
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Affiliation(s)
- Guoqi Shen
- Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, 221000, China
| | - Haiyan He
- Department of Cardiology, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou, 221000, China
| | - Xudong Zhang
- Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, 221000, China
| | - Linsheng Wang
- Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, 221000, China
| | - Zhen Wang
- Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, 221000, China
| | - Fangfang Li
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China
| | - Yuan Lu
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China.
| | - Wenhua Li
- Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, 221000, China.
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China.
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Abdalla MA, Ahmed KO, Yousef BA. Incidence and Risk Factors of Contrast-Induced Acute Kidney Injury in Sudanese Patients Undergoing Coronary Angiography: A Descriptive Prospective Study. Cureus 2022; 14:e21876. [PMID: 35273847 PMCID: PMC8901158 DOI: 10.7759/cureus.21876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 11/05/2022] Open
Abstract
Background: Contrast-induced acute kidney injury (CI-AKI) has been reported to be the third most common cause of hospital-acquired acute kidney injury (AKI) and is associated with significant morbidity and mortality. Objectives: This study aimed to assess the incidence and risk factors of CI-AKI in Sudanese patients undergoing coronary angiography. Methods: The study was a descriptive, prospective, hospital-based study conducted at Alshaab Hospital between January and April 2019. A total of 163 patients undergoing coronary angiography were enrolled, and a checklist was used to collect data. Chi-square and regression analyses were performed to identify the risk factors of CI‑AKI. CI‑AKI was defined as a rise in serum creatinine ≥25% above baseline within three days after percutaneous coronary angiography (PCA). Results: CI‑AKI incidence in patients undergoing coronary angiography was 31.9% (52/163). Among independent variables, diabetes mellitus, the type of coronary angiography, and the volume of contrast medium were statistically significantly (p-value ˂ 0.05) associated with CI-AKI development. Logistic analysis showed that diabetes (odds ratio (OR): 15.2; 95% CI: 6.771-33.974; p = 0.001), percutaneous coronary intervention (PCI) (OR: 2.4; 95% CI: 1.168-4.901; p = 0.017), and the volume of contrast medium (OR 2.1; 95% CI: 1.440-3.054; p = 0.001) were independent predictors correlated to CI‑AKI development. Conclusion: The incidence of CI-AKI is 31.9%, and diabetes mellitus, PCI, and high volume of contrast medium are associated with a higher risk of CI-AKI in patients undergoing coronary angiography.
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A Simple Nomogram to Predict Contrast-Induced Acute Kidney Injury in Patients with Congestive Heart Failure Undergoing Coronary Angiography. Cardiol Res Pract 2021; 2021:9614953. [PMID: 33859840 PMCID: PMC8009707 DOI: 10.1155/2021/9614953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 02/12/2021] [Accepted: 03/10/2021] [Indexed: 11/30/2022] Open
Abstract
Background Patients with congestive heart failure (CHF) are vulnerable to contrast-induced kidney injury (CI-AKI), but few prediction models are currently available. Therefore, we aimed to establish a simple nomogram for CI-AKI risk assessment for patients with CHF undergoing coronary angiography. Methods A total of 1876 consecutive patients with CHF (defined as New York Heart Association functional class II-IV or Killip class II-IV) were enrolled and randomly (2:1) assigned to a development cohort and a validation cohort. The endpoint was CI-AKI defined as serum creatinine elevation of ≥0.3 mg/dL or 50% from baseline within the first 48–72 hours following the procedure. Predictors for the simple nomogram were selected by multivariable logistic regression with a stepwise approach. The discriminative power was assessed using the area under the receiver operating characteristic (ROC) curve and was compared with the classic Mehran score in the validation cohort. Calibration was assessed using the Hosmer–Lemeshow test and 1000 bootstrap samples. Results The incidence of CI-AKI was 9.06% (170) in the total sample, 8.64% (n = 109) in the development cohort, and 9.92% (n = 61) in the validation cohort (P=0.367). The simple nomogram including four predictors (age, intra-aortic balloon pump, acute myocardial infarction, and chronic kidney disease) demonstrated a similar predictive power as the Mehran score (area under the curve: 0.80 vs. 0.75, P=0.061), as well as a well-fitted calibration curve. Conclusions The present simple nomogram including four predictors is a simple and reliable tool to identify CHF patients at risk of CI-AKI, whereas further external validations are needed.
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Liang W, Yu CJ, Wang QY, Yu J. Anemia is associated with increased risk of contrast‑induced acute kidney injury: A Systematic Review and Meta-analysis. Bioengineered 2021; 12:648-661. [PMID: 33595423 PMCID: PMC8806332 DOI: 10.1080/21655979.2021.1883887] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Previous studies have identified numerous risk factors of contrast-induced acute kidney injury (CI-AKI) in patients undergoing coronary angiography. However, the association between anemia and CI-AKI remains conflicting. Thus, we conducted a meta-analysis to further clarify the relationship between anemia and CI-AKI. PubMed, EMBASE and Web of Science were systematically searched from inception to June 2020 to identify eligible studies. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to estimate the correlation between anemia and CI-AKI. The potential publication bias was estimated using funnel plot and Begg’s test. A total of 13 studies (five case-control studies and eight cohort studies) comprising 27,135 patients were included. The pooled results showed that anemia was a significant risk factor of CI-AKI (OR, 1.82; 95% CI, 1.27–2.61). Moreover, the results of subgroup analyses and sensitivity analyses were basically consistent with the overall pooled result. Funnel plot and Begg’s test indicated that there existed potential publication bias, but the result of trim and filled analysis showed that the pooled results kept stable after adding ‘missing’ studies. This meta-analysis suggested that anemia may be correlated with an increased incidence of CI-AKI in patients undergoing coronary angiography. However, our conclusions should be interpreted with caution due to some limitations. Therefore, further high-quality trials should be conducted to confirm our findings.
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Affiliation(s)
- Wei Liang
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University , Lanzhou, China
| | - Cheng Jie Yu
- Medical Records Department, Lanzhou University First Hospital, Lanzhou University , Lanzhou, China
| | - Qiong Ying Wang
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University , Lanzhou, China
| | - Jing Yu
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University , Lanzhou, China
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