Abstract 11755: Impact of Minimum Contrast Media on Percutaneous Coronary Intervention for Preventing Contrast Induced Nephropathy in Patients with Coronary Artery Disease
Backgrounds: Contrast induced nephropathy (CIN) following percutaneous coronary intervention (PCI) is an important complication. It is well known that diabetes mellitus (DM), chronic kidney disease and large contrast media volume (CMV) usage are risk factors for the incidence of CIN. However, clinical effect of minimum CMV PCI (CMV ≤ 50ml) to prevent the CIN have not been well evaluated. The purpose of this study was to evaluate the impact of minimum CMV PCI to prevent the incidence of CIN.
Method: Consecutive 2052 patients who underwent elective PCI were enrolled, and we measured serum creatinine (S-Cr) level at baseline and 48 hours after PCI. The incidence of CIN was defined as absolute S-Cr increase of 0.5 mg/dl or relative 25% increase over baseline S-Cr level.
Results: CIN occurred in 160 (7.8%). Multivariate logistic regression analysis revealed that elderly patients (age ≥ 75 y.o.), DM, complex lesion and CMV were significantly associated with CIN, suggesting elderly patients with DM and complex lesion were as high risk patients for CIN. We divided patients into two subgroups according to the CMV usage; minimum CMV group: CMV < 50ml (n=94) and non-minimum CMV group: CMV ≥ 50ml (n=1958). Incidence of CIN was significantly lower in the minimum CMV group than non-minimum CMV group (2.1 % v.s. 8.1%; p=0.03). When analyzed only in non high risk patietns, incidence of CIN was not different between minimum CMV and non-minimum CMV group (0% v.s. 4.9%; p=0.31). However, incidence of CIN was significantly lower in the minimum CMV group than that of non-minimum CMV group in the high risk patients, (2.6 % v.s. 10.4%; p=0.03).
Conclusion: Minimum CMV PCI could reduce the incidence of CIN, and minimum CMV PCI had more important value for preventing CIN in the high risk patients compared to the non-high risk patients. We can use the value of minimum CMV (≤50ml) as one of the clinical cut off value for preventing the CIN
- © 2011 by American Heart Association, Inc.