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Effect of Vigileo/FloTrac System-Guided Aggressive Hydration in Acute Myocardial Infarction Patients to Prevent

Weiwei Ling1, Zichao Jiang1, Ke Liu1

  • 1Department of Cardiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China.

The American Journal of Cardiology
|April 5, 2023
PubMed

Insights

Aggressive hydration guided by the Vigileo/FloTrac system significantly reduced contrast-induced nephropathy (CIN) risk in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI). This tailored approach also helped avoid acute heart failure post-procedure.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Devices

Background:

  • Contrast-induced nephropathy (CIN) is a risk for patients undergoing percutaneous coronary intervention (PCI), especially those with acute myocardial infarction (AMI).
  • Current hydration strategies may not be optimal for preventing CIN in this high-risk population.
  • The Vigileo/FloTrac system offers potential for monitoring fluid responsiveness and guiding hydration.

Purpose of the Study:

  • To evaluate the efficacy of aggressive hydration, guided by the Vigileo/FloTrac system, in preventing CIN in patients with AMI undergoing urgent PCI.
  • To compare the incidence of CIN between Vigileo/FloTrac-guided hydration and general hydration protocols.

Main Methods:

  • A prospective, multicenter, randomized controlled, open-label study involving 344 patients with AMI undergoing urgent PCI.
  • Patients were randomized to either Vigileo/FloTrac-guided aggressive hydration (intervention) or general hydration (control).
  • CIN was defined as a >25% or >0.5 mg/100 ml increase in serum creatinine within 72 hours post-PCI.

Main Results:

  • The Vigileo/FloTrac-guided group received significantly more hydration (1,910 ± 600 ml) compared to the control group (440 ± 90 ml).
  • The incidence of CIN was significantly lower in the intervention group (12.1%) versus the control group (22.2%) (p=0.013).
  • No significant difference in acute heart failure incidence (9.2% vs 7.6%) or major adverse cardiovascular events (17.3% vs 22.2%) was observed between groups.

Conclusions:

  • Vigileo/FloTrac system-guided aggressive hydration is an effective strategy for reducing CIN risk in AMI patients undergoing urgent PCI.
  • This method safely prevents CIN without increasing the risk of acute heart failure.
  • Tailored hydration guided by hemodynamic monitoring shows promise for improving patient outcomes post-PCI.

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