Abstract 19881: Low Contrast Technique Significantly Reduces Rate of Contrast-induced Nephropathy (CIN)
Background: Contrast induced nephropathy (CIN) after percutaneous cardiovascular procedures is associated with worse short and long term outcomes. A risk score by Mehran et al [incorporating dye amount, age, diabetes, anemia, heart failure, hypotension and intra-aortic balloon pump] is commonly used for predicting CIN risk. However, the minimal amount of contrast used to validate this score was 100 cc. We hypothesized that minimizing the IVC amount utilizing a 3 cc syringe and selected views could decrease CIN rates below the predicted value.
Methods: We abstracted data from diagnostic and therapeutic (including coronary, peripheral and valve interventions) procedures from 2010-2013 in patients with serum creatinine > 1.5 mg/dl. All coronary and non-coronary diagnostic and interventional procedures were performed utilizing the 3cc low contrast technique and limited, focused views. We documented the occurrence of CIN (Increase in 25% and/or 0.5 mg/dl in serum creatinine at 24-72h post procedure). We then calculated the predicted risk based on the risk score and used the one sample proportion test to compare the actual and predicted CIN rates.
Results: We had complete data on 67 sequential patients with mean creatinine of 2.1 mg/dl (+/-0.5). The mean amount of contrast used per patient was 26.6 cc (+/-15). In these high-risk patients, the actual incidence of CIN was significantly lower than the predicted incidence [3 patients (4.5%) vs. 23(34%); p<0.001;Figure 1].
Conclusions: Thus, aggressive and mindful minimization of contrast utilization using a 3cc syringe and focused angiographic views decreased the rate of CIN by more than 7 fold the predicted rate.
Author Disclosures: A. Benjo: None. S. Saberian: None. G. Nadkarni: None. J.H. Lee: None. T. Collins: None. S. Ramee: None.
- © 2014 by American Heart Association, Inc.