Analysis of Biomarkers for Risk of Acute Kidney Injury After Primary Angioplasty for Acute ST-Segment Elevation Myocardial Infarction: Results of the HORIZONS-AMI Trial/Guerchicoff et al./2015/United States of America/Catheter Cardiovasc Interv(18). |
Cohort/Level 4. |
To analyze whether contrast-induced acute kidney injury (AKI) can occur after percutaneous coronary intervention. |
Analyzing 390 patients 14.3% developed CIN In this group, the levels of type B natriuretic peptide were higher than in the group without AKI at the beginning of the study (P <0.03), hospital discharge (P <0.001), follow-up 30 days (P <0.01) and 1 year follow-up (P <0.03). At hospital discharge, there was an increase in D-dimer (P <0.01), C-reactive protein (P <0.04), selective adhesion molecule of endothelial cells (P <0.01), adiponectin (P <0.03) and von Willebrand factor (P <0.01), compared to the group without AKI. |
The risk of CIN after primary percutaneous coronary intervention for acute myocardial infarction with ST-segment elevation may be associated with hemostatic imbalances, activation of pro coagulants, decreased endogenous anticoagulants, inflammation, platelet activation or reduced fibrinolytic activity. |
Contrast-induced nephropathy after primary angioplasty for acute myocardial infarction/Santos et al./2015/Brazil/ J Bras Nefrol(19). |
Cohort/Level 4. |
To determine the incidence and factors associated with CIN in patients with acute myocardial infarction undergoing angioplasty in the first 12 hours after the onset of symptoms. |
The total sample was 201 patients. CIN incidence was 23.8%. In the univariate analysis, patients with CIN were older and with a higher frequency of left ventricular ejection fraction=40% and Killip classification=2. |
CIN affects a quarter of patients with acute myocardial infarction undergoing angioplasty without predictive variables. |
One-year results of the ICON (Ionic versus non-Ionic Contrast to Obviate worsening Nephropathy after angioplasty in chronic renal failure patients) Study/Giustino et al./ 2016/United States of America/J Catheter Cardiovasc Interv(20). |
Randomized, double-blind, multicenter clinical trial/ Level 2. |
To assess differences in mortality, acute myocardial infarction or PCI, at 1 year after exposure to non-ionic iso-osmolar contrast medium (IOCM) or low-osmolar ion contrast medium (LOCM) in patients with chronic kidney disease undergoing angiography coronary. |
The total sample was 146 patients. In 1 year, three deaths (4.1%) occurred in the LOCM group and nine deaths in the IOCM group (13.6%, P <0.07). The 1-year cardiac mortality rate was 2.7% in the LOCM group and 9.1% in the IOCM group (P <0.07). There were no significant differences in the rates of myocardial infarction (1.4% vs. 1.5%; P=1.00) and repeated revascularization (6.8% vs. 9.1%; P=0.75). |
Using ionic ioxaglate (LOCM) has been associated with numerically lower mortality in 1 year compared to iodixanol (IOCM) in patients undergoing cardiac catheterization. |
Off-Hour Primary Percutaneous Coronary Angioplasty Does Not Affect Contrast Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction/Velibey et al./2017/Turkey/J Angiology(21). |
Retrospective control case/Level 6. |
To assess whether primary PCI outside working hours (weekdays from 17:01 to 19:00) is related to an increased incidence of CIN. |
The total sample was 2556 patients. The group outside working hours was more often admitted with acute symptoms of heart failure (16.4% vs 7.8%, P <0.001) and more contrast was injected (235.2 ± 82.3 vs 248.9 ± 87.1 ml, P <0.002). There was a trend towards higher hospital mortality when PCI was performed outside working hours (1.9% vs 0.7%, P=0.081). There was no significance with increased risk for CIN (Odds Ratio: 1.051, P=0.833). |
CIN incidence did not increase during non-working hours, and PCI outside working hours is not a risk factor for CIN, despite an apparent increase in the use of contrast medium during off-hour PCI. |
Preventive effect of statin pretreatment on contrast-induced acute kidney injury in patients undergoing coronary angioplasty propensity score analysis from a multicenter registry/Hoshi et al./2014/Japan/Int J Cardiol(22). |
Retrospective and multicenter control case/ Level 6. |
To investigate whether statin pretreatment prevents CIN in patients with coronary artery disease undergoing PCI. |
Of 2,198 patients, a total of 8.7% developed CIN. In the propensity-resected groups, the incidence of CIN was significantly lower in patients with pretreatment with statin than in those without pretreatment (3.5% vs. 10.6%, odds ratio [OR]: 0.31, 95% confidence interval (P <0.001). Multivariate logistic regression analysis showed that the pre-treatment group remained a negative predictor independent of CIN (OR: 0.31, 95% CI, P <0.001) among subjects with propensity. |
Pre-treatment with statin has been associated with a significant decrease in the risk of CIN in patients with coronary artery disease undergoing PCI. |