scholarly journals BUDGET IMPACT OF CONTRAST MEDIA CHOICE AND CONTRAST INDUCED ACUTE KIDNEY INJURY IN HIGH-RISK PATIENTS UNDERGOING INVASIVE CORONARY ANGIOGRAPHY WITH OR WITHOUT PERCUTANEOUS CORONARY INTERVENTION FROM A US HOSPITAL PERSPECTIVE

2016 ◽  
Vol 19 (3) ◽  
pp. A299
Author(s):  
T.M. Todoran ◽  
S. Goldfarb ◽  
C. Peña ◽  
C. Ferrufino ◽  
S. Kowal ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Budget Impact ◽  
Invasive Coronary Angiography ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Hospital Perspective ◽  
Percutaneous Coronary ◽  
Risk Patients

scholarly journals Incidence of Acute Kidney Injury Is Lower in High-Risk Patients Undergoing Percutaneous Coronary Intervention Supported with Impella Compared to ECMO

2021 ◽  
Author(s):  
Julian Schweitzer ◽  
Patrick Horn ◽  
Fabian Voss ◽  
Milena Kivel ◽  
Georg Wolff ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
High Risk ◽  
Mechanical Circulatory Support ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Circulatory Support ◽  
Risk Allocation ◽  
Percutaneous Coronary ◽  
Risk Patients ◽  
Va Ecmo

AbstractAcute kidney injury (AKI) is a common complication post-PCI. Here, in a single-center observational registry, we compared the frequency of AKI in patients at elevated risk for AKI (based on Mehran risk stratification scoring) who underwent VA-ECMO- or Impella-supported high-risk PCI. A total of 28 patients scheduled for elective high-risk PCI with mechanical circulatory support were studied prospectively. All patients were turned down for surgery due to exceedingly high risk. Allocation to VA-ECMO (n=11) or Impella (n=17) was performed according to site-specific restrictions on the daily availability of the VA-ECMO platform as a prospective enrollment and performed prior to initiation of PCI. We analyzed AKI incidence as our primary endpoint, as well as PCI success, duration, and peripheral complications. All patients were successfully revascularized and had MCS weaned at the end of the procedure. Baseline GFR and procedural contrast media were similar. Despite similar risks for AKI as calculated by the Mehran score (35 ± 18.9 vs. 31 ± 16.6 %; p=0.55), patients supported by Impella during PCI demonstrated a reduced incidence of AKI (55 vs. 12 %; p=0.03). MCS-assisted high-risk PCI with VA-ECMO or Impella is feasible. However, Impella is associated with a shorter procedure time and a lower incidence of AKI.

Impella support and acute kidney injury during high‐risk percutaneous coronary intervention: The Global cVAD Renal Protection Study

2019 ◽  
Vol 95 (6) ◽  
pp. 1111-1121 ◽  
Author(s):  
Michael P. Flaherty ◽  
Jeffrey W. Moses ◽  
Ralf Westenfeld ◽  
Igor Palacios ◽  
William W. O'Neill ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Renal Protection ◽  
Percutaneous Coronary

TWILIGHT: A Randomized Trial of Ticagrelor Monotherapy Versus Ticagrelor Plus Aspirin Beginning at 3 Months in High-risk Patients Undergoing Percutaneous Coronary Intervention

2020 ◽  
Vol 14 ◽  
Author(s):  
Johny Nicolas ◽  
Usman Baber ◽  
Roxana Mehran
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Bleeding Events ◽  
High Risk Patients ◽  
Risk Of Death ◽  
Percutaneous Coronary ◽  
Risk Patients

A P2Y12 inhibitor-based monotherapy after a short period of dual antiplatelet therapy is emerging as a plausible strategy to decrease bleeding events in high-risk patients receiving dual antiplatelet therapy after percutaneous coronary intervention. Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention (TWILIGHT), a randomized double-blind trial, tested this approach by dropping aspirin at 3 months and continuing with ticagrelor monotherapy for an additional 12 months. The study enrolled 9,006 patients, of whom 7,119 who tolerated 3 months of dual antiplatelet therapy were randomized after 3 months into two arms: ticagrelor plus placebo and ticagrelor plus aspirin. The primary endpoint of interest, Bleeding Academic Research Consortium type 2, 3, or 5 bleeding, occurred less frequently in the experimental arm (HR 0.56; 95% CI [0.45–0.68]; p<0.001), whereas the secondary endpoint of ischemic events was similar between the two arms (HR 0.99; 95% CI [0.78–1.25]). Transition from dual antiplatelet therapy consisting of ticagrelor plus aspirin to ticagrelor-based monotherapy in high-risk patients at 3 months after percutaneous coronary intervention resulted in a lower risk of bleeding events without an increase in risk of death, MI, or stroke.

scholarly journals Nutritional status and risk of contrast-associated acute kidney injury in elderly patients undergoing percutaneous coronary intervention

2021 ◽  
Author(s):  
Xiaoqi Wei ◽  
Hanchuan Chen ◽  
Zhebin You ◽  
Jie Yang ◽  
Haoming He ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Severe Malnutrition ◽  
Percutaneous Coronary ◽  
Conut Score

Abstract Background This study aimed to investigate the connection between malnutrition evaluated by the Controlling Nutritional Status (CONUT) score and the risk of contrast-associated acute kidney injury (CA-AKI) in elderly patients who underwent percutaneous coronary intervention (PCI). Methods A total of 1308 patients aged over 75 years undergoing PCI was included. Based on the CONUT score, patients were assigned to normal (0–1), mild malnutrition (2–4), moderate-severe malnutrition group (≥ 5). The primary outcome was CA-AKI (an absolute increase in ≥ 0.3 mg/dL or ≥ 50% relative serum creatinine increase 48 h after contrast medium exposure). Results Overall, the incidence of CA-AKI in normal, mild, moderate-severe malnutrition group was 10.8%, 11.0%, and 27.2%, respectively (p < 0.01). Compared with moderate-severe malnutrition group, the normal group and the mild malnutrition group showed significant lower risk of CA-AKI in models adjusting for risk factors for CA-AKI and variables in univariate analysis (odds ratio [OR] = 0.48, 95% confidence interval [CI]: 0.26–0.89, p = 0.02; OR = 0.46, 95%CI: 0.26–0.82, p = 0.009, respectively). Furthermore, the relationship were consistent across the subgroups classified by risk factors for CA-AKI except anemia. The risk of CA-AKI related with CONUT score was stronger in patients with anemia. (overall interaction p by CONUT score = 0.012). Conclusion Moderate-severe malnutrition is associated with higher risk of CA-AKI in elderly patients undergoing PCI.

Sign in / Sign up

Export Citation Format

Share Document