P0142CONTRAST INDUCED NEPHROPATHY AFTER CORONARY ANGIOGRAPHY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Durdona Saipova ◽  
Shavkat Muminov ◽  
Baxodir Nigmanov ◽  
Kamila Olimxanova
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Serum Creatinine ◽  
Functional State ◽  
Negative Relationship ◽  
Serum Creatinine Concentration ◽  
Contrast Induced Nephropathy ◽  
Creatinine Concentration ◽  
Artery Disease

Abstract Background and Aims Determination of markers of kidney damage in patients with coronary artery disease after coronary angiography. HYPERLINK “https://www.healthline.com/health/coronary-angiography” Method The study included 303 patients with coronary artery disease who were planned coronary angiography. The initial examination of patients included an assessment of the structural and functional state of the kidneys, metabolic profile and the functional state of the cardiovascular system. Renal filtration function was assessed by the clearance of creatinine and cystatin C with the calculation of glomerular filtration rate (eGFRcr and eGFRcis) All coronary artery disease patients included in the study underwent coronary angiography using a contrast drug unigexole. If there is necessity, stenting of the coronary arteries was performed. On the 2nd day after coronary angiography, a serum creatinine concentration was determined to isolate patients in whom coronary angiography was complicated by CIN. Contrast induced nephropathy was defined as an increase in serum creatinine concentration by 25% 24 hours after coronarography. According to the study, patients were divided into 2 groups - 67.99% of patients with an uncomplicated postoperative period of caranoroangiography; CIN (-) group and CIN (+) group 32.01% of patients who developed contrast-induced nephropathy. Subsequently, the CIN + and CIN- groups were retrospectively compared according to the initial hemodynamic parameters, structural and functional state of the kidneys, and metabolic characteristics. Results The results of the study showed that eGFRcr did not significantly differ in the CIN(+) and CIN(-) groups, although it turned out to be lower in both groups. (p <0.05). While eGFRcis in the CIN(+) group was significantly lower than in patients with uncomplicated coronary angiography. Correlation analysis showed a reliable positive average relationship between the values of eGFRcr and eGFRcis in the CIN(+) group (r = 0.32, p <0.001). Correlation revealed a reliable average negative relationship between eGFRcis and the relative density of urine (r = -0.46, p <0.001), indicating a combined violation of the glomerular and canalicular function of the kidneys, which indicates that in these patients, despite the preserved eGFRcr, pathogenetic markers of impaired renal function are detected. The Resistance Index (RI), which characterizes the resistance of the microvasculature of the kidneys in all patients with coronary artery disease significantly exceeded the control values. The selected groups according to the value of RI were arranged as follows: the minimum value of RI is in the CIN(–) without diabetes mellites group, and the maximum value is in patients with СIN(+) and diabetes mellitus. Conclusion In patients with coronary artery disease undergoing endovascular procedures, eGFRcis is a more accurate indicator of latent impaired renal filtration function than eGFRcr. Decrease in eGFRcis below 89ml / min in patients with coronary artery disease at risk of developing contrast-induced nephropathy during caranoroangiography. An increase in RI of segmental arteries of the kidneys is associated with a decrease in the filtration function of the kidneys and patients with maximum RI have the greatest risk of developing glomerular dysfunction under conditions of exposure to contrast.

scholarly journals MO169FUNCTIONAL STATE OF THE KIDNEYS IN PATIENT AFTER CORONARY REVASCULARIZATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Shavkat Muminov ◽  
Durdona Saipova
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Serum Creatinine ◽  
Coronary Revascularization ◽  
Early Period ◽  
Serum Creatinine Concentration ◽  
Ckd Progression ◽  
Creatinine Concentration ◽  
Artery Disease

Abstract Background and Aims The aim of the study was to study the functional state of the kidneys in patients with coronary artery disease in the long-term period after coronary revascularization. Method There were 160 patients with coronary artery disease under observation who underwent re-endovascular procedures (RE). The average age of the patients was 56.6 ± 1.27 years. The study included patients with an eGFR of at least 60 ml / min, determined by the serum creatinine concentration. A dynamic determination of the serum creatinine concentration was carried out to isolate patients in whom the postoperative REB was complicated by contrast-induced nephropathy (CIN). In the present study, CIN was defined as an increase in serum creatinine concentration by 25% 24 or more hours after REB. In the future, all patients underwent dynamic determination of serum creatinine concentration in terms of 3 months - 1 year -2 years. Patients received standard therapy for coronary artery disease: antiplatelet therapy (in the case of stenting of coronary arteries - double therapy), bisoprolol, valsartan, atorvastatin. Results The results of the study showed that during 2 years of follow-up after coronary revascularization, a progressive decrease in eGFR was observed. So, by the 3rd month, eGFR decreased by -17.39 ± 1.17%, by the end of the 1st year - by -43.62 ± 1.28%, by the end of the second year of observation - by -46.50 ± 1.79%. At the same time, the decrease in eGFR was significantly more pronounced in the group of patients who had CIN in the early period after endovascular intervention (37 patients): (-39.82 ± 2.02% by the end of the 3rd month, -54.61 ± 2.94% by the end of the 1st year and -60.10 ± 3.99% by the end of the 2nd year of observation versus -10.65 ± 0.57%, -40.32 ± 1, 27% and -42.41 ± 1.85% in patients with CIN-, respectively, p <0.001 for intergroup comparisons of the relative dynamics of eGFR at all three time points). Conclusion Thus, the present study has demonstrated that in patients with coronary artery disease after revascularization, there is a significant decrease in the glomerular filtration function of the kidneys as early as 3 months after the endovascular procedure. CKD progression continues for at least 2 years after revascularization. One of the predictors of CKD progression is the development of CIN in the early period after endovascular intervention.

scholarly journals Association of Creatinine Clearance Rate and Coronary Angiographic Severity in Patients with Coronary Artery Disease

2015 ◽  
Vol 7 (2) ◽  
pp. 108-113
Author(s):  
Mofazzal Hossain ◽  
HI Lutfur Rahman Khan ◽  
Abdul Wadud Chowdhury ◽  
Abu Sadique Abdullah ◽  
Md Gaffar Amin ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Clearance Rate ◽  
Negative Relationship ◽  
Creatinine Clearance Rate ◽  
Vessel Disease ◽  
Artery Disease ◽  
Vessel Score

Background: In epidemiological studies and clinical trials renal function has been shown to be an independent predictor of coronary artery disease (CAD). We conducted this study to find out the association between creatinine clearance rate (CCr) and coronary angiographic severity in patients with (CAD). Method: It was a cross sectional study carried out in the department of Cardiology, Dhaka Medical College Hospital, Dhaka during the period of April, 2011 to March, 2012. All the patients with Ischaemic heart disease (IHD) admitted in the department of Cardiology who fulfill the inclusion and exclusion criteria and underwent coronary angiogram were taken as sampling population. Sampling technique was purposive and sample size was 118. By Cockcroft-Gault formula, CCr was estimated from serum creatinine. Coronary angiographic severity of coronary artery disease was assessed by vessel score and stenosis score. Statistical analysis was carried out by descriptive statistics, correlation coefficient test and one way ANOVA test. Level of significance was set at 0.05. Results: Mean CCr among study subjects was 72.57 ± 17.78 ml/min. Vessel score showed 18.6% had normal coronaries, 37.3% single vessel disease, 31.4% double vessel disease and 12.7% triple vessel disease. There was significant positive relationship between serum creatinine and vessel score, and also negative relationship between CCr and vessel score. The study also showed significant negative correlation between CCr and stenosis score. Conclusion: Angiographic severity of coronary artery disease is associated with degree of renal dysfunction. Decreased creatinine clearance is associated with more extensive CAD. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22257 Cardiovasc. j. 2015; 7(2): 108-113

scholarly journals CONTRAST-INDUCED NEPHROPATHY;

2017 ◽  
Vol 24 (11) ◽  
pp. 1598-1604
Author(s):  
Naeem Asghar ◽  
Liaqat Ali ◽  
Wasiq Anees
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Local Population ◽  
Common Finding ◽  
Diabetic Patients ◽  
Coronary Angiogram ◽  
Contrast Induced Nephropathy ◽  
History Of ◽  
Artery Disease

Introduction: Contrast induced nephropathy (CIN) is a disorder characterizedby the onset of acute renal failure within 24 to 72 hours after the administration of iodinatedcontrast medium after coronary angiography. CIN is associated with prolonged hospitalizationand adverse clinical outcomes. The objective of this study is to determine the frequency ofcontrast induced nephropathy in patients of coronary artery disease undergoing coronaryangiography in local population. Setting: Department of Cardiology, Faisalabad Instituteof Cardiology. Period: 16-04-2016 to 15-10-2016. Subjects and Methods: 200 patients ofcoronary artery disease booked for coronary angiogram. Study design was Cross-sectional.Baseline characteristic and history of risk factors of coronary artery disease were noted. Serumcreatinine level was recorded at baseline and after 48 hours of angiography by sending bloodsample to the hospital pathology department and were noted. Contrast induced nephropathywas assessed. Results: Mean age of the patients was 53.61±12.48 year. Patients with agebetween 30-50 years were 76(38%) and patients with age 51-70 years were 124 (62%). Outof 200 patients, 130 (65%) were males while remaining 70 (35%) were females. In the studypopulation 14 (7%) developed contrast induced nephropathy (CIN). Mostly patients of 51-70years of age group developed CIN. CIN was reported in 9(6.92%) male patients and 5(7.1%)female patients. Among diabetic 4 (3.57%) patient developed CIN. Among hypertensive patients2 (2.77%) patient developed CIN. Similarly in patients presented with acute coronary syndrome8 (7.61%) patient developed CIN. Conclusion: In conclusion, contrast induced nephropathy inpatients with coronary artery disease undergoing coronary angiogram was found in 7%. CIN isa relative common finding following coronary angiography in patients especially in elderly andmale patients. More incidences of CIN were noted in patients presented with acute coronarysyndrome and in diabetic patients.

P1585Increased circulating galectin 1 level is associated with progression of kidney function decline in patients with suspected coronary artery disease, independent of diabetes

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C S Kuo ◽  
R H Chou ◽  
Y W Lu ◽  
S J Lin ◽  
P H Huang
Keyword(s):  
Coronary Artery Disease ◽  
Renal Function ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Kidney Function ◽  
Suspected Coronary Artery Disease ◽  
Contrast Induced Nephropathy ◽  
Baseline Serum ◽  
Renal Function Decline ◽  
Artery Disease

Abstract Background Galectin-1 modulates acute and chronic inflammation, and is associated with glucose homeostasis and chronic renal disease. Whether serum Galectin-1 levels could predict the short-term and long-term renal outcomes after contrast exposure in patients with suspected coronary artery disease remains uncertain. Purpose This study aimed to evaluate the relationship between serum Galectin-1 levels and the incidence of contrast-induced nephropathy and to investigate the predictive role of circulating galectin-1 levels in renal function decline in patients undergoing coronary angiography. Methods In total, 798 patients who had received coronary angiography were enrolled. Serum galectin-1 levels were determined before administration of contrast media. Contrast-induced nephropathy was defined as a rise in serum creatinine of 0.5 mg/dL or a 25% increase from baseline within 48 h after the procedure. Progressive renal function decline was defined as >30% decrease in estimated glomerular filtration rate after discharge. All patients were followed up for at least one year or until the occurrence of death after coronary angiography. Results Overall, contrast-induced nephropathy occurred in 41 (5.1%) patients. During a median follow-up of 1.4±1.1 years, 80 (10.0%) cases had subsequent decline in renal function. After adjustment for demographic characteristics, kidney function, traditional risk factors, and medications, higher galectin-1 level was found to be independently associated with a higher risk for mortality and renal function decline (tertile 2, HR=3.12 95% CI,1.25–7.78; tertile 3, HR=3.25, 95% CI,1.42–7.41) but not for contrast-induced nephropathy, regardless of the presence of diabetes. Conclusions Higher baseline serum galectin-1 levels were associated with a higher risk of mortality and renal function decline in patients undergoing coronary angiography. Galectin-1 may play a pivotal role in progressive renal dysfunction, but further studies are needed to verify these results. Acknowledgement/Funding Ministry of Science and Technology of Taiwan (MOST 104-2314-B-075-047), Taipei Veterans General Hospital (V105C-0207, V106C-045, V108C-195)

Coronary Artery Disease Screening Using CT Coronary Angiography

2020 ◽  
Vol 91 (10) ◽  
pp. 812-817
Author(s):  
Randy Wang Long Cheong ◽  
Brian See ◽  
Benjamin Boon Chuan Tan ◽  
Choong Hou Koh
Keyword(s):  
Systematic Review ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Cardiac Risk ◽  
Disease Screening ◽  
Ct Coronary Angiography ◽  
Major Adverse Cardiovascular Events ◽  
Cardiac Events ◽  
Artery Disease

BACKGROUND: The increased utility of CT coronary angiography (CTCA) in cardiovascular screenings of aircrew has led to the increased detection of asymptomatic coronary artery disease (CAD). A systematic review of studies relevant to the interpretation of CTCA for the occupational fitness assessment of high-risk vocations was performed, with findings used to describe the development of a pathway for the aeromedical disposition of military aviators with asymptomatic CAD.METHODS: Medline was searched using the terms CT coronary angiogram and screening and prognosis. The inclusion criteria were restricted to study populations ages > 18 yr, were asymptomatic, were not known to have CAD, had undergone CTCA, and with their associations with major adverse cardiovascular events (MACE) and other relevant cardiac outcomes reported.RESULTS: Included in this systematic review were 10 studies. When compared to subjects with no or nonobstructive CAD, those with obstructive CAD on CTCA had hazard ratios (HR) for cardiac events ranging from 1.42 to 105.48. Comparing subjects with nonobstructive CAD and those without CAD on CTCA, a lower HR of 1.19 for cardiac events was found. The annual event rates of subjects with no CAD on CTCA were extremely low, ranging from 0 to 0.5%.CONCLUSIONS: Based on the findings, we suggest that CTCA should only be performed in aircrew with higher cardiac risk profiles. Those found to have no CAD or minimal CAD (i.e., 25% stenosis) in a non-left main coronary artery on CTCA can be returned to flying duties. All other results should be further evaluated with an invasive angiogram.Cheong RWL, See B, Tan BBC, Koh CH. Coronary artery disease screening using CT coronary angiography. Aerosp Med Hum Perform. 2020; 91(10):812817.

scholarly journals Accuracy of MSCT Coronary Angiography with 64 Row CT Scanner—Facing the Facts

2010 ◽  
Vol 4 ◽  
pp. CMC.S3864 ◽  
Author(s):  
M. Wehrschuetz ◽  
E. Wehrschuetz ◽  
H. Schuchlenz ◽  
G. Schaffler
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Potential ◽  
Coronary Artery Stenoses ◽  
Artery Disease ◽  
Msct Angiography

Improvements in multislice computed tomography (MSCT) angiography of the coronary vessels have enabled the minimally invasive detection of coronary artery stenoses, while quantitative coronary angiography (QCA) is the accepted reference standard for evaluation thereof. Sixteen-slice MSCT showed promising diagnostic accuracy in detecting coronary artery stenoses haemodynamically and the subsequent introduction of 64-slice scanners promised excellent and fast results for coronary artery studies. This prompted us to evaluate the diagnostic accuracy, sensitivity, specificity, and the negative und positive predictive value of 64-slice MSCT in the detection of haemodynamically significant coronary artery stenoses. Thirty-seven consecutive subjects with suspected coronary artery disease were evaluated with MSCT angiography and the results compared with QCA. All vessels were considered for the assessment of significant coronary artery stenosis (diameter reduction ≥ 50%). Thirteen patients (35%) were identified as having significant coronary artery stenoses on QCA with 6.3% (35/555) affected segments. None of the coronary segments were excluded from analysis. Overall sensitivity for classifying stenoses of 64-slice MSCT was 69%, specificity was 92%, positive predictive value was 38% and negative predictive value was 98%. The interobserver variability for detection of significant lesions had a κ-value of 0.43. Sixty-four-slice MSCT offers the diagnostic potential to detect coronary artery disease, to quantify haemodynamically significant coronary artery stenoses and to avoid unnecessary invasive coronary artery examinations.

Sign in / Sign up

Export Citation Format

Share Document