Impact of Transient or Persistent Contrast-induced Nephropathy on Long-term Mortality After Elective Percutaneous...

Area of Science:

• Nephrology
• Cardiology
• Clinical Research

Background:

• Contrast-induced nephropathy (CIN) is a known complication following procedures using contrast media.
• The long-term prognostic implications of CIN remain debated, with uncertainty whether it's a causal factor or a marker of patient risk.

Purpose of the Study:

• To investigate the independent association between persistent and transient contrast-induced nephropathy (CIN) and long-term mortality after elective percutaneous coronary intervention (PCI).

Main Methods:

• Analysis of 5,516 patients undergoing first-time elective PCI from the Kyoto registry cohort-2.
• CIN defined as serum creatinine elevation ≥0.5 mg/dl within 5 days post-PCI.
• Subgroup analysis of persistent CIN (≥0.5 mg/dl at 1 year) and transient CIN (<0.5 mg/dl at 1 year) versus non-CIN, with adjustment for 37 confounders.

Main Results:

• Overall CIN occurred in 4.0% of patients and was independently associated with increased long-term mortality (HR 1.43).
• Persistent CIN was identified in 1.3% of patients and significantly correlated with higher long-term mortality (HR 1.84, p=0.02) compared to non-CIN.
• Transient CIN (2.3%) did not show a significant association with increased long-term mortality (HR 1.11, p=0.6).

Conclusions:

• Persistent CIN following PCI is an independent predictor of increased long-term mortality.
• Transient CIN does not appear to carry a similar increased long-term mortality risk.
• These findings underscore the clinical significance of sustained kidney function impairment after contrast exposure during PCI.