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Periprocedural hemoglobin drop and contrast-induced nephropathy in percutaneous coronary intervention patients

Kang Hyu Lee1, Sang Rok Lee, Kyung Pyo Kang

  • 1Division of Cardiology, Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.

Korean Circulation Journal
|February 26, 2010
PubMed

Insights

A drop in hemoglobin greater than 1 g/dL during periprocedural care is a significant predictor of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI). This finding aids in identifying patients at higher risk for CIN.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Radiology

Background:

  • Contrast-induced nephropathy (CIN) increases mortality and cardiovascular risks post-percutaneous coronary intervention (PCI).
  • The association between CIN and hemoglobin levels has been debated.
  • Identifying novel risk factors for CIN is crucial for patient management.

Purpose of the Study:

  • To assess the clinical utility of periprocedural hemoglobin drop as a risk factor for CIN.
  • To investigate the relationship between hemoglobin changes and CIN development after PCI.

Main Methods:

  • A cohort of 537 patients undergoing PCI was studied.
  • Patients were categorized into two groups: those who developed CIN (n=51) and those who did not (n=486).
  • Iodixanol was used as the contrast agent; CIN was defined by a specific rise in serum creatinine within 48 hours.

Main Results:

  • No significant differences in baseline cardiovascular risk factors were observed between groups, except for anthropometric measures and baseline hemoglobin.
  • Patients who developed CIN had lower pre-PCI and post-PCI hemoglobin levels.
  • A periprocedural hemoglobin drop exceeding 1 g/dL was identified as an independent predictor of CIN via logistic regression analysis.

Conclusions:

  • A periprocedural hemoglobin drop of >1 g/dL is a significant independent predictor of CIN.
  • This finding holds true even when using less nephrotoxic contrast agents like iodixanol.
  • Hemoglobin drop serves as an important, previously underappreciated, risk factor for CIN in PCI patients.
Abstract

Keywords:
AnemiaContrast mediaHemoglobinRenal insufficiency

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