Race, contrast-induced nephropathy and long-term outcomes after coronary and peripheral angiography and intervention

Area of Science:

• Cardiovascular Medicine
• Nephrology
• Medical Interventions

Background:

• Contrast-induced nephropathy (CIN) is a recognized complication following diagnostic angiography and interventional procedures.
• Investigating the influence of patient race on CIN development is crucial for understanding disparities in procedural outcomes.

Purpose of the Study:

• To examine the association between race and the incidence of contrast-induced nephropathy (CIN).
• To evaluate the long-term effects of race on renal dysfunction, dialysis initiation, and mortality after angiography and intervention.

Main Methods:

• A cohort study involving 4070 patients undergoing coronary and peripheral angiography/intervention.
• Analysis of CIN incidence at 72 hours, renal dysfunction at 3 months, and long-term hemodialysis and mortality rates over 5 years.
• Statistical comparison of outcomes between Caucasian and non-Caucasian patient groups using odds ratios and confidence intervals.

Main Results:

• No significant difference in CIN incidence at 72 hours (7.1% vs. 6.6%) or renal dysfunction at 3 months (11.24% vs. 11.52%) between Caucasian and non-Caucasian patients.
• A significantly lower rate of dialysis initiation in Caucasian patients (0.64%) compared to non-Caucasians (1.88%) after 5 years (P=0.0004).
• No significant difference in 5-year mortality rates between the racial groups (20.28% vs. 20.44%).

Conclusions:

• Race is not a significant predictor for the development of CIN or short-term renal dysfunction post-angiography.
• Caucasian patients demonstrated a significantly lower long-term risk of requiring dialysis compared to non-Caucasian patients.
• While race did not influence overall mortality, disparities in long-term renal replacement therapy initiation were observed.