Impact of an Early Decrease in Systolic Blood Pressure on The Risk of Contrast-Induced Nephropathy after Percutaneous Coronary Intervention - 29/12/15

Doi : 10.1016/j.hlc.2015.07.013

Hualong Li, MD ^a,^{^{1
These authors (Hualong Li, Shuijin Huang, Yiting He) contributed equally to this work.}}, Shuijin Huang, MD ^b,^{^{1
These authors (Hualong Li, Shuijin Huang, Yiting He) contributed equally to this work.}}, Yiting He, MD ^c,^{^{1
These authors (Hualong Li, Shuijin Huang, Yiting He) contributed equally to this work.}}, Yong Liu, MD ^a,^⁎ , Yuanhui Liu, MD ^a, Jiyan Chen, MD ^a, Yingling Zhou, MD ^a,^⁎ , Ning Tan, MD ^a,^⁎ , Chongyang Duan, MS ^d, Pingyan Chen, MS ^d
^a Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
^b Guangzhou First People's Hospital, Guangzhou, Guangdong, China
^c The First People's Hospital of Shunde, Shunde, Guangdong, China
^d National Clinical Research Center for Kidney Disease, Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, China

^⁎Corresponding authors at: No. 106 Zhongshan Second Road, Guangzhou, 510080, Guangdong, China. Tel.: +86-20-83819161; fax: +02083851483

Résumé

Background

The early postprocedural period was thought to be the rush hour of contrast media excretion, causing rapid and prolonged renal hypoperfusion, which was the critical time window for contrast-induced nephropathy (CIN).

Methods

349 consecutive patients were enrolled into the study. The relation between an early postprocedural decrease in systolic blood pressure (SBP) and the risk of CIN was assessed using multivariate logistic regression.

Results

A postprocedural decrease in SBP was observed in 63% of patients and CIN developed in 28 (8.0%) patients. The CIN group had a lower postprocedural SBP (114.5±13.5 vs. 123.7±15.6mmHg, P=0.003) and a greater postprocedural decrease in SBP (16.2±19.1 vs. 5.9±18.7mmHg, P=0.005) than the no-CIN group. ROC analysis revealed that the optimum cutoff value for the SBP decrease in detecting CIN was >10mmHg (sensitivity 60.7%, specificity 59.5%, AUC=0.66). Multivariate logistic regression analysis found that a postprocedural decrease in SBP >10mmHg was a significant independent predictor of CIN (OR 2.368, 95%CI: 1.043–5.379, P=0.039), after adjustment for other risk factors.

Conclusion

An early moderate postprocedural decrease in SBP may increase the risk of CIN in patients undergoing PCI.

Le texte complet de cet article est disponible en PDF.

Keywords : Contrast-induced nephropathy, Systolic blood pressure, Haemodynamic instability, Percutaneous coronary intervention

Plan

Introduction

Materials and Methods

Clinical Characteristics of Patients

In-hospital Complications of CIN

SBP Decrease and Risk of CIN

Export

Vol 25 - N° 2

P. 118-123 - février 2016 Retour au numéro

Article précédent

Incidence, Predictors and Outcomes of Major Bleeding in Patients Following Percutaneous Coronary Interventions in Australia
John Wlodarczyk, Andrew E. Ajani, Dante Kemp, Nick Andrianopoulos, Angela L. Brennan, Stephen J. Duffy, David J. Clark, Christopher M. Reid

| Article suivant

Long-term Outcomes of Patients with Acute Myocardial Infarction Presenting to Regional and Remote Hospitals
Sradha Kotwal, Isuru Ranasinghe, David Brieger, Philip Clayton, Alan Cass, Martin Gallagher

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

connectez-vous ou créez un compte

Impact of an Early Decrease in Systolic Blood Pressure on The Risk of Contrast-Induced Nephropathy after Percutaneous Coronary Intervention - 29/12/15

Résumé

Background

Methods

Results

Conclusion

Plan

Export citations

Fichier

Contenu

Accès rapides

Mon compte

Aide & support

Plateformes Elsevier Masson

Déclaration CNIL