Abstract 17812: Race is Not Associated with Contrast-Induced Nephropathy but is Associated with Long-Term Initiation of Dialysis After Cardiac Catheterization and Coronary Intervention
Background: Contrast-induced nephropathy (CIN) is a complication of diagnostic angiography and percutaneous coronary and endovascular intervention. It is associated with diabetes and chronic kidney disease, both diseases which are associated with poorer outcomes in non-Caucasians. We investigated the effect of race in the development of CIN .
Methods and Results: We studied 2201 predominantly (98%) male patients undergoing peripheral and coronary angiography and percutaneous coronary and endovascular intervention at a veterans’ administration medical center. We analyzed the incidence of CIN at 72 hours, of renal dysfunction at 3 months as well as the incidence of hemodialysis. CIN was defined as either a rise in creatinine of 25% or an absolute rise in creatinine of 0.5 mg/dl. The mean age was 68.2 years. The Caucasian patients (n=1446) were significantly older, had a lower baseline creatinine, lower rates of hypertension and diabetes compared to the non-Caucasian patients. Information on creatinine at 3 days was available on 1062 patients and on creatinine at 3 months on 1937 patients. CIN occurred in 56 (7.9%) Caucasian patients (n=711 patients) and in 31 (8.8%) non-Caucasians at 72 hours after the procedure (odds ratio [OR] 0.76; 95% confidence interval [CI] 0.42 - 1.37; P=0.36). At 3 months, renal dysfunction was seen in 77 (15.04%) Caucasian patients (n=512) versus 49 (16.72%) of the non-Caucasian group (OR 0.88, CI 0.60 - 1.30; P=0.53). On multivariate analysis, after adjustment for age, comorbidities and baseline creatinine, Caucasian race was not significantly associated with CIN at 72 hours (OR=0.94, 95% CI 0.40 - 2.33, P=0.89) or with renal dysfunction at 3 months (OR= 1.2, 95% CI 0.78 - 2.0, P=0.35). After a median follow up of 67 months, of the 2201 patients 12 patients (0.8 %) of the Caucasian group were placed on dialysis versus 26 (3.4 %) of the non-Caucasian group (HR 0.20, CI 0.08 - 0.47; P<0.0001).
Conclusions: In this cohort of patients, race was not associated with the development of CIN at 72 hours, or the development of renal dysfunction at 3 months post procedure. In the long-term, the rate of initiation of dialysis after was significantly higher in the non-Caucasian patients.
- © 2011 by American Heart Association, Inc.