Abstract 4737: Predictors of Contrast-Induced Nephropathy After Use of Non-Ionic Contrast Media During Percutaneous Coronary Intervention
Backgrounds: Contrast-induced nephropathy (CIN), defined as the elevation of serum creatinine more than 20% of the baseline level after percutaneous coronary intervention, has been increasing recently. However, the preventive strategy for CIN remains unclear. The aim of this study was to assess the incidence and predictors of CIN when non-ionic contrast media (Visipaque®) was used.
Methods: Between January 2005 and July 2008, 339 patients (68.9±9.1 years of age, 294 men) who had baseline creatinine level >1.3 mg/dl after diagnostic coronary angiography (CAG) or percutaneous coronary intervention (PCI) were analyzed. The patients were divided into two groups according to the rate of increase in the serum creatinine; Group I (>20%) and Group II (<20%).
Results: CIN developed in 18 patients (4.6%). They were more likely to have diabetes (23.8% vs 13.6%, p=0.009), decreased left ventricular ejection fraction (LVEF) (50.23±14.0% vs. 58.7±13.3%, p<0.001), lower body mass index (22.9±3.2 vs. 24.0±3.2, p=0.006), and lower baseline hematocrit level (33.5±4.9% vs. 37.0±5.5%, p<0.001). Independent risk factors for CIN were decreased LVEF (HR=1.05; 95% CI, 1.079–1.017, p=0.002) and a history of diabetes (HR=3.13; 95% CI, 1.218 – 8.041, p=0.0018). The amount of contrast media as a predictor of CIN by ROC curve was 165cc.
Conclusion: Predictors of CIN after use of non-ionic contrast media during PCI were decreased LV systolic function and a history of diabetes.