Predictive value of plasma volume status for contrast-induced nephropathy in patients with heart failure undergoing elective percutaneous coronary intervention

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C He ◽  
K Lin ◽  
H Chen ◽  
H He ◽  
J Yang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Percutaneous Coronary Intervention ◽  
Plasma Volume ◽  
Predictive Value ◽  
Coronary Intervention ◽  
Volume Status ◽  
Contrast Induced Nephropathy ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Patients With Heart Failure

Abstract   Predictive value of plasma volume status for contrast-induced nephropathy in patients with heart failure undergoing elective percutaneous coronary intervention. Objective Contrast-induced nephropathy (CIN) remains a common complication of coronary procedure and increases poor outcomes, especially in patients with heart failure. Plasma volume expansion relates to worsening prognosis of heart failure. We hypothesised that calculated plasma volume status (PVS) might provide predictive utility for contrast-induced nephropathy in patients with heart failure undergoing elective percutaneous coronary intervention (PCI). Methods We enrolled 441 patients with heart failure undergoing PCI from 2012 to 2018. Pre-procedural PVS was calculated by comparing actual plasma volume (aPV) derived from the Hakim formula to ideal plasma volume (iPV). CIN was defined as an absolute SCr increase ≥0.5 mg/dl within 72h of contrast medium exposure. We assessed the association between PVS and risk of contrast-induced nephropathy in patients with heart failure undergoing elective PCI. Results In 441 patients, 28 (6.3%) patients developed CIN. The median pre-procedural PVS was −0.02 (−0.09–0.05). The best cutoff value of PVS for predicting CIN was 0.04 with 64.5% sensitivity and 75.5% specificity according to the ROC analysis (C statistic = 0.718; 95% CI: 0.674–0.760),of which predictive value is similar to NT-proBNP (C statistics 0.721 vs. 0.773, P=0.355). After adjusting for potential confounding risk factors, multivariable analysis demonstrated that PVS >0.04 (OR=3.142, 95% CI: 1.185–8.332, P<0.05) and NT-proBNP >4518pg/ml (OR=7.591, 95% CI: 2.886–19.968, P<0.05)were strong independent predictors of CIN. Conclusion Pre-procedural PVS is an independent risk factor for predicting CIN markedly, of which predictive value is comparable to BNP and also independent of BNP. The best cutoff point of PVS for predicting CIN was 0.04. ROC for PVS and NT-proBNP to predict CIN Funding Acknowledgement Type of funding source: None

scholarly journals Efficacy and Safety of Nicorandil in Preventing Contrast-Induced Nephropathy after Elective Percutaneous Coronary Intervention: A Pooled Analysis of 1229 Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Bin Yi ◽  
Shaoyan Mo ◽  
Yumei Jiang ◽  
Dingwu Yi ◽  
Jinwen Luo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Coronary Intervention ◽  
Pooled Analysis ◽  
Efficacy And Safety ◽  
Contrast Induced Nephropathy ◽  
Elective Percutaneous Coronary Intervention ◽  
Recurrent Myocardial Infarction ◽  
Percutaneous Coronary ◽  
Major Adverse Events

Background. Nicorandil in reducing contrast-induced nephropathy (CIN) following elective percutaneous coronary intervention (PCI) is an inconsistent practice. This article aims to evaluate the efficacy and safety of nicorandil in preventing CIN after elective PCI. Methods. This is a pooled analysis of patients treated with elective PCI. The primary outcome was the incidence of CIN. The secondary outcomes were major adverse events, including mortality, heart failure, recurrent myocardial infarction, stroke, and renal replacement therapy. Results. A total of 1229 patients were recruited in our study. With statistical significance, nicorandil lowered the risk of CIN (odds ratio = 0.26; 95% confidence interval = 0.16–0.44; P<0.00001; I2 = 0%) in patients who underwent elective PCI. In addition, no significant differences were observed in the incidence of mortality, heart failure, recurrent myocardial infarction, stroke, and renal replacement therapy between the two groups (P>0.05). Conclusions. Our article indicated that nicorandil could prevent CIN without increasing the major adverse events. Furthermore, sufficiently powered and randomized clinical studies are still needed in order to determine the role of nicorandil in preventing CIN after elective PCI.

scholarly journals Omega-3 Supplementation in the Prevention of Contrast Induced Nephropathy in Patients Undergoing Elective Percutaneous Coronary Intervention: A Randomized Placebo-Controlled Trial

2019 ◽  
Vol 9 (2) ◽  
pp. 307-313 ◽  
Author(s):  
Farzaneh Foroughinia ◽  
Mahtabalsadat Mirjalili ◽  
Ehsan Mirzaei ◽  
Alireza Oboodi
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cystatin C ◽  
Coronary Intervention ◽  
Protective Role ◽  
Control Group ◽  
Omega 3 ◽  
Contrast Induced Nephropathy ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Hydration Therapy

Purpose: Contrast-induced nephropathy (CIN) is the third cause of hospital-acquired renal failure and is associated with significant morbidity and mortality. Several studies have revealed the protective role of omega-3 in prevention and treatment of some kidney injuries. This study was conducted to examine the effect of omega-3 supplementation on the markers of renal function and to evaluate its potential in the prevention of CIN in patients undergoing elective percutaneous coronary intervention (PCI). Methods: In this double-blind, randomized clinical trial, 85 eligible patients scheduled for PCI was randomly divided into omega-3 (a single 3750 mg dose of omega-3 as well as routine hydration therapy within 12 hours before PCI) or control (placebo plus routine hydration therapy) groups. Serum creatinine (SCr) and cystatin C levels were measured at baseline and 24 hours after PCI. Results: Our results indicated that post- PCI cystatin C levels were significantly decreased in the omega-3 group compared to the control group (P < 0.001). Although less upward manner was seen in the level of 24-hour creatinine in the omega-3 group, it did not reach the significance level (P = 0.008). Conclusion: The positive effect of omega-3 on cystatin C levels showed that it may have a protective role in the prevention of CIN in post-PCI patients with normal kidney function. However, to better assess this effect, it is highly recommended to design future studies with higher doses and longer duration of therapy with omega-3 plus long-term follow up.

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