Abstract 3461: Contrast-Induced Nephropathy After Percutaneous Coronary Intervention is Associated With High Long-Term Mortality: Insights From CREDO-Kyoto Registry
Background: Contrast-induced nephropathy (CIN) is the third leading cause of hospital-acquired renal failure accounting for 10% of all cases. However, long-term prognostic implication of CIN is unknown at present.
Methods: CREDO-Kyoto is a multi-center registry of Japanese patients who underwent first percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG) between January 2000 and December 2002. CIN was defined as an elevation in serum creatinine concentration >=0.5mg/dl from preprocedure values within 2 days after PCI or before discharge. Patients underwent CABG, on hemodialysis before catheterization, without laboratory data, and died during the index hospitalization were excluded.
Results: Of 4362 patients from 30 institutions, 228 (5.2%) developed CIN. The median follow up period was 1258 days. The Kaplan-Meier curve demonstrates the survival after discharge for patients with and without CIN. The survival for patients with CIN after PCI was much lower than those without CIN (Log-rank, p<.0001). Cox proportional hazard model showed that older age, non-obese, malignancy, peripheral arterial disease, congestive heart failure, chronic obstructive pulmonary disease, reduced left ventricular function, multi-vessel disease, anemia, renal insufficiency, current smoker, hypertension, and diabetes were independent risk factors for the mortality. CIN was associated with high long-term mortality [hazard ratio: 1.44, 95% confidence interval: 1.13–1.68] even after adjustment for above factors.
Conclusions: CIN after PCI occurred in one to 20 patients and was shown the independent risk factor for the mortality after discharge.