PP.09.16] PREDICTORS AND PROGNOSIS OF CONTRAST-INDUCED ACUTE KIDNEY INJURY IN PATIENTS WITH ELECTIVE PERCUTANEOUS INTERVENTION

Abstract

Objective: Contrast-induced acute kidney injury (CI-AKI) is one of the most common complications after percutaneous coronary intervention (PCI) using intravascular radiocontrast media. CI-AKI has been associated with high in-hospital mortality and poor long-term survival. The aim of the study was to evaluate the incidence, risk factors and outcomes of CI-AKI in patients with elective PCI. Design and method: 150 patients with stable angina pectoris (SAP) and elective PCI (102 male, 61.3 ± 11.2 years (M ± SD), arterial hypertension 88%, previous MI 56%, diabetes mellitus 25%, known chronic kidney disease (CKD) 33%, anemia 17%, heart failure 67%, left ventricular ejection fraction 42 ± 16%) were examined. CI-AKI was defined using 2012 KDIGO Guidelines. Isoosmolar contrast media iodixanol (Visipaque-320) or low-osmolar contrast media iohexol (Omnipaque-350) were used. Transradial access for PCI was used in 98% of patients. Mann-Whitney test and multivariate logistic regression analysis were performed. P Results: 21 (14%) patients developed CI-AKI. Stages 1 and 2 of CI-AKI were found in 92 and 8% of cases accordingly. Main independent predictors of CI-AKI were contrast media volume (CV)/eGFR > 4.35 (odds ratio (OR) 20.2; 95% confidence interval (CI) 3.4–120.8; p 10 (OR 14.7; 95% CI 1.2–66.6; p 350 ml (OR 8.7; 95% CI 1.4–21.5; p 74.5 years (OR 6.9; 95% CI 1.4–34.1; p 96 μmol/l (OR 5.5; 95% CI 1.4–21.5; p Conclusions: CI-AKI in patients with SAP and elective PCI developed in 14% of cases, predominantly stage 1. Main independent predictors of CI-AKI were factors related to the contrast media (CV/eGFR, CV) and factors related to the patient (CKD, Mehran risk score > 10, age > 74.5 years, baseline eGFR 96 μmol/l, anemia). CI-AKI had negative impact on of 6 months rehospitalizations.