Abstract 3134: Prognostic Implications of Contrast-Induced Nephropathy After Percutaneous Coronary Intervention in Patients With and Without Chronic Kidney Disease: Insights From CREDO-Kyoto Registry
Background: Although contrast-induced nephropathy (CIN) is the third leading cause of hospital-acquired renal failure, long-term prognostic implication of CIN in patients with and without chronic kidney disease (CKD) is unknown at present.
Methods: We have enrolled 9873 patients who underwent first percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG) at 30 institutions into CREDO-Kyoto registry. After exclusion of patients underwent CABG, on hemodialysis before catheterization, without laboratory data, and died during the index hospitalization, 4333 patients remained. CKD and CIN were defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 and an elevation in serum creatinine >= 0.5mg/dl from baseline, respectively.
Results: Of 1805 patients with CKD, 179 (9.9%) developed CIN after PCI. During median follow up of 1237 days, 235 patients (13.0%) died and the survival for patients with CIN was much lower than those without CIN (Log-rank, p<.0001) (Figure⇓). Cox proportional hazard model showed that CIN was associated with high long-term mortality [hazard ratio: 1.47, 95% confidence interval: 1.17–1.83] after adjustment for other risk factors for death. Of 2528 patients without CKD, 47 (1.9%) developed CIN after PCI. During median follow up of 1289 days, 136 patients (5.4%) died and the survival for patients with CIN was, however, similar to those without CIN (p = 0.3).
Conclusions: CIN after PCI occurred in one to 10 patients with CKD and one to 50 patients without CKD. CIN was shown the independent risk factor for the mortality after discharge among patients with CKD, but not patients without CKD.