S18-YIA-3 RISK FACTORS AND CLINICAL OUTCOMES FOR CONTRAST INDUCED NEPHROPATHY POST PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH NORMAL BASELINE RENAL FUNCTION

2007 ◽  
Vol 122 ◽  
pp. S33
Author(s):  
Eric Chong ◽  
Liang Shen ◽  
Yiong H. Chan ◽  
Huay C. Tan
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Renal Function ◽  
Clinical Outcomes ◽  
Coronary Intervention ◽  
Contrast Induced Nephropathy ◽  
Percutaneous Coronary ◽  
Baseline Renal Function

Contrast-induced nephropathy associated factors in patients with significant coronary obstruction

2021 ◽  
pp. 1-11
Author(s):  
Alberto Hernández González ◽  
Caridad de Dios Soler Morejón ◽  
Teddy Osmin Tamargo Barbeito
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Coronary Occlusion ◽  
Coronary Intervention ◽  
Contrast Nephropathy ◽  
Contrast Induced Nephropathy ◽  
Percutaneous Coronary ◽  
Coronary Obstruction

Coronary intervention is associated with the appearance of contrast-induced nephropathy. The purpose of the study was to assess the risk of developing contrast-induced nephropathy in patients with significant coronary obstruction and its relationship with known risk factors for this nephropathy. A prospective cohort study was designed with 160 patients treated at the cardiocenter of the “Hermanos Ameijeiras” hospital, Cuba, who underwent invasive coronary angiography, between January 2016 and July 2017. The average age was 61.6 ± 9 ,2 years; 70.6% were men. The personal pathological history of ischemic heart disease (85.6%) and arterial hypertension (75.6%) predominated. 75% of the cases presented a significant coronary occlusion. The frequency of contrast nephropathy was 42.5%. The factors that had an important statistical relationship with the presence of significant arterial occlusion were known ischemic heart disease (p <0.001), previous percutaneous coronary intervention (p = 0.007), creatinine after the procedure (p = 0.043) and CIN (p = 0.016) as well as the volume of contrast administered (p = 0.006). In the subgroup of patients with significant occlusion, low hematocrit (p = 0.025) and emergency percutaneous coronary intervention (p = 0.007) were the most influential factors. It is concluded that patients with significant coronary occlusion have an increased risk for the development of contrast nephropathy. The correction of those risk factors that are modifiable (such as low hematocrit) and the correct application of the hydration protocol are essential to prevent this complication.

P45945-years clinical outcomes of patients underwent percutaneous coronary intervention for calcified lesions with rotational atherectomy and second-generation drug eluting stent

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Ogata ◽  
H Koiwaya ◽  
K Shinzato ◽  
Y Goriki ◽  
G Yoshioka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Clinical Outcomes ◽  
Second Generation ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Diabetic Mellitus ◽  
Percutaneous Coronary ◽  
Drug Eluting

Abstract Background Percutaneous coronary Intervention (PCI) with rotational atherectomy (RA) was useful for severe calcified lesions. However, the long-term clinical outcomes of PCI with second-generation drug eluting stent (DES) following RA has been still unclear. Purpose The purpose of this study was to investigate the long-term clinical outcomes of RA followed by second-generation DES. Methods We retrospectively enrolled 254 consecutive patients treated with second-generation DES following RA. The primary outcome was the cumulative 5-year incidence of MACE, defined as cardiac death, myocardial infarction, clinically-driven target lesion revascularization and definite stent thrombosis. Results The incidence of MACE was 22.8% at 5-years. Multivariate analysis showed 3 predictors of MACE, hemodialysis, diabetic mellitus and extremely angulated lesions (>90°).Significantly higher MACE was observed in the high-risk (≥2 risk factors) group, compared with the low-risk (2< risk factors) group (68.7% vs. 18.7%, P<0.001, Figure). Multivariate analysis for MACE at 5 year Hazard ratio (95% Confidence Interval) P-value Diabetic Mellitus 2.58 (1.35–4.91) 0.004 Hemodialysis 4.57 (1.64–12.76) 0.004 extremely angulated (>90°) 3.08 (1.06–8.93) 0.04 Kaplan-Meier curves for 5-years MACE Conclusions The long-term clinical outcomes of PCI for severely calcified lesions was acceptable. However, the clinical outcomes of patients classified high risk cohort was unsatisfactory.

Percutaneous Coronary Intervention–Related Bleeding Risk Factors in Current Practice

2005 ◽  
Vol 39 (10) ◽  
pp. 1627-1633 ◽  
Author(s):  
A Scott Mathis ◽  
James J Gugger
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Renal Function ◽  
Length Of Stay ◽  
Bleeding Risk ◽  
Coronary Intervention ◽  
Bleeding Complications ◽  
Minor Bleeding ◽  
Prolonged Length ◽  
Percutaneous Coronary

BACKGROUND: Bleeding is a common and costly complication of percutaneous coronary intervention (PCI). Little is known about the risk factors for bleeding complications. Objective: To report our PCI-related observations from a single institution and use the information to establish risk factors for short-term bleeding complications, with special focus on examining the importance of renal function. METHODS: A retrospective record review was conducted of the admission of 300 patients grouped according to antithrombotic regimen: unfractionated heparin alone (n = 187), bivalirudin (n = 26), and glycoprotein IIb/IIIa antagonist plus heparin (n = 103). Bleeding and ischemic outcomes were tracked. A model was constructed to predict independent bleeding risk factors. RESULTS: Treatment groups differed significantly regarding any bleeding (p = 0.001), minor bleeding (p < 0.001), and length of stay (p = 0.01). Multivariate predictors of any bleeding included antithrombotic regimen, creatinine clearance (Clcr) <30 mL/min, and hypertension. Any bleeding was associated with prolonged length of stay. Major bleeding was predicted by Clcr <30 mL/min and was associated with prolonged length of stay and death. Minor bleeding was predicted only by choice of antithrombotic regimen. CONCLUSIONS: The major influences on bleeding risk appeared to be Clcr <30 mL/min and choice of antithrombotic regimen. It is important to note that other markers of renal function, including serum creatinine value and serum creatinine at a cutoff level of 1.5 mg/dL, did not predict bleeding events.

Outcomes after percutaneous coronary intervention for chronic total occlusion according to baseline renal function

2017 ◽  
Vol 107 (3) ◽  
pp. 259-267 ◽  
Author(s):  
Barbara E. Stähli ◽  
Cathérine Gebhard ◽  
Michael Gick ◽  
Miroslaw Ferenc ◽  
Kambis Mashayekhi ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Renal Function ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Total Occlusion ◽  
Percutaneous Coronary ◽  
Baseline Renal Function

Abstract 3705: Risk factors and Clinical Outcomes for Contrast Induced Nephropathy Post Percutaneous Coronary Intervention in Patients with Normal baseline Renal Function

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Eric Chong ◽  
Liang Shen ◽  
Yiong H Chan ◽  
Huay C Tan
Keyword(s):  
Diabetes Mellitus ◽  
Renal Function ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Clinical Predictors ◽  
Contrast Induced Nephropathy ◽  
Ventricular Ejection Fraction ◽  
Percutaneous Coronary ◽  
Baseline Renal Function

Background: Contrast induced nephropathy (CIN) is an important complication post percutaneous coronary intervention (PCI). We examine the risk factors for developing CIN in patients with normal baseline renal function so that prophylactic measures may be undertaken to prevent its development. Methods: A cohort of 5086 patients with normal baseline renal function (defined as serum creatinine <1.5mg/dl) who did not receive prophylactic treatment while undergoing PCI (primary or elective) between May 1996 to March 2007 in our centre was enrolled in the study. We examine the occurrence of CIN (defined as >25% increase from baseline creatinine within 48 hours post PCI) in 3036 subjects of this cohort with available creatinine data and aim to identify the clinical predictors. Results: CIN occurred in 7.3% of the patients. The mean age of these patients was 57.5 yrs, 78.7% were men, and 34.6% had diabetes mellitus. Clinical predictors for CIN were age (OR 6.4, 95% CI 0.1–13.3, p=0.042), female gender (OR 2.0, 95% CI 1.5–2.7, p=0.001), lower left ventricular ejection fraction (OR 1.02, 95% CI 1.01–1.04, p=0.01), anemia with hemoglobin <11mg/dl (OR 1.5 (95% CI 1.01–2.4, p=0.044) and systolic hypotension with blood pressure <100mmHg on admission(OR 1.5, 95% CI 1.01–2.2, p=0.004). While there was no increase in the incidence of CIN among diabetics and nondiabetics (8.2% vs 6.8%, p=0.18), those who are on insulin therapy are at the highest risk compared with diabetics on diet control and oral hypoglycemic drugs (18.9% vs 3.6% vs 6.8%, p=0.001). There was no significant difference between patients who underwent primary vs elective PCI (7.0% vs. 6.6% p=0.75). Patients who developed CIN had higher mortality rate at 1 month (14.5% vs 1.1%, p<0.001) and 6 month (17.8% vs 2.2%, p<0.001) Conclusion: Patients with normal baseline renal function undergoing PCI are also at risk of developing CIN with resultant higher mortality. Age, female, insulin dependent diabetes mellitus, hypotension, anemia, low left ventricular ejection fraction are predictors of CIN. Such patients should also be considered CIN prophylactic therapy.

scholarly journals Prognostic Value of Estimated Glomerular Filtration Rate 3–6 Months after Percutaneous Coronary Intervention

2020 ◽  
pp. 1-9
Author(s):  
Won Jik Lee ◽  
Dong-Bin Kim ◽  
Sung-Ho Her ◽  
Chul Soo Park ◽  
Jong-Min Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Group 1

<b><i>Background:</i></b> The prognostic significance of follow-up (f/u) renal function for patients undergoing percutaneous coronary intervention (PCI) remains unknown. This study sought to investigate the prognostic implications of f/u renal function in patients undergoing PCI. <b><i>Methods:</i></b> A drug-eluting stent registry was used. We divided patients into 4 groups according to the change in the estimated glomerular filtration rate (eGFR) before PCI and 3–6 months after PCI. Patients with normal pre-PCI eGFR and f/u eGFR were assigned to group 1. Those with normal pre-PCI eGFR and abnormal f/u eGFR were assigned to group 2. Patients with abnormal pre-PCI eGFR and normal f/u eGFR were assigned to group 3. Patients with abnormal pre-PCI eGFR and f/u eGFR were allocated into group 4. <b><i>Results:</i></b> A total of 4,899 PCI patients were enrolled. The death rate in group 1, 2, 3, and 4 at 3 years was 2, 11, 4, and 9%, respectively. This showed significant differences between groups, except between groups 2 and 4. The prognosis of a group with aggravation from normal renal function was worse than that of a group with recovery from abnormal renal function. A prediction model that combines clinical risk factors and f/u eGFR has more power for predicting clinical outcomes than a combination of clinical risk factors and pre-PCI eGFR. <b><i>Conclusion:</i></b> Post-PCI eGFR was more accurate for predicting patient outcomes than pre-PCI eGFR.

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