Relationship between contrast-induced nephropathy and long-term mortality after percutaneous coronary intervention in
Tuncay Güzel1, Adem Aktan2, Muhammed Demir3
1Diyarbakir Gazi Yaşargil Training and Research Hospital, Department of Cardiology - Diyarbakır, Turkey.
Insights
Contrast-induced nephropathy after coronary angiography for chronic total occlusion significantly increases long-term mortality. Prophylactic measures and close patient monitoring are recommended to reduce adverse events.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Chronic total occlusion (CTO) interventions are complex, requiring prolonged procedures and significant contrast dye.
- Contrast-induced nephropathy (CIN) is a known complication of angiography, potentially impacting patient outcomes.
Purpose of the Study:
- To investigate the association between contrast-induced nephropathy and long-term mortality in patients undergoing coronary angiography for CTO lesions.
Main Methods:
- A cohort of 218 patients with CTO lesions from three centers underwent procedural coronary angiography.
- Patients were stratified into groups based on CIN development.
- All-cause mortality was tracked over a 100-month follow-up period.
Main Results:
- Patients who developed CIN had a significantly higher long-term mortality rate (57.1% vs. 42.9%, p<0.001).
- Kaplan-Meier analysis revealed shorter survival in the CIN group.
- Logistic regression identified CIN as an independent predictor of mortality (OR 11.78).
Conclusions:
- Contrast-induced nephropathy is significantly associated with increased long-term mortality in CTO patients.
- Prophylactic strategies and vigilant post-procedure follow-up may mitigate adverse events.
Objective:
Intervention in chronic total occlusion lesions involves long procedure time, a serious contrast load, and complex procedures. In this study, we aimed to investigate mortality rate of patients who had procedural coronary angiography done for chronic total occlusion lesions in coronary angiography series and who developed contrast-induced nephropathy.
Methods:
A total of 218 patients with chronic total occlusion lesion in at least one coronary artery, from three different medical centers, who underwent procedural coronary angiography were recruited for the study. Patient population was divided into two groups: those who developed contrast-induced nephropathy and those who did not. Mortality due to all causes was investigated between both groups throughout a 100-month follow-up.
Results:
Mean age of patients with incidence of contrast-induced nephropathy was 66.7±11.8, and 23.8% of them were comprised by female. We found a significantly higher mortality in long-term follow-up in the patient group with contrast-induced nephropathy (42.9 vs. 57.1%, p=<0.001). According to Kaplan-Meier analysis performed additionally, survival during follow-up was significantly shorter in this group and, in logistic regression analysis, it was an independent predictor of mortality (OR 11.78; 95%CI 3.38-40.9).
Conclusion:
We identified that the development of contrast-induced nephropathy is associated with long-term mortality. It might be possible to reduce adverse events with prophylactic approaches before the procedure and close follow-up of such patients after the procedure.
More Related Videos
10:03Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
06:02Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
Published on: April 18, 2013
Related Concept Videos
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention