PP.14.31] RISK FACTORS AND PROGNOSIS OF CONTRAST-INDUCED ACUTE KIDNEY INJURY IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION

Abstract

Objective: Contrast-induced acute kidney injury (CI-AKI) is a serious potentially preventable complication of percutaneous coronary interventions (PCI). It remains a challenge as use of PCI is growing, patient population is aging, diabetes and chronic kidney disease are coming more common. The risk factors and prognosis of CI-AKI are not well defined. The aim of the study was to evaluate the risk factors and prognosis of CI-AKI in patients undergoing PCI. Design and method: 502 patients (346 male, 64 ± 12 years (M ± SD), arterial hypertension 92%, previous myocardial infarction 38%, diabetes mellitus (DM) 22%, known chronic kidney disease 19%, anemia 16%, heart failure 62%, left ventricular ejection fraction 40 ± 16%) who underwent PCI (stable angina pectoris (SAP), n = 50; unstable AP/non-ST-segment elevation myocardial infarction (UAP/NSTEMI), n = 236; STEMI, n = 216) were examined. CI-AKI was defined using 2012 KDIGO Guidelines. Mann-Whitney test and multivariate logistic regression analysis were performed. P < 0.05 was considered statistically significant. Results: 18% of total population, in SAP patients 12%; UAP/NSTEMI, 15%; STEMI, 20%, developed CI-AKI (p < 0.01). Patients with versus without CI-AKI in total population were older (68 ± 13 vs 63 ± 12 years, p < 0.05), had higher baseline SCr (114 ± 31 vs 92 ± 23 μmol/l, p < 0.05), white blood cells (WBC) (11.08 ± 2.41 vs 9.62 ± 3.86, p < 0.05), higher rate of DM (25 vs 15%, p < 0.05),), anemia (30 vs 15%, p < 0.05) and higher rate of main left coronary artery disease (29 vs 15%, p < 0.01), higher contrast media volume/estimated glomerular filtration rate ratio (CV/eGFR) (4.32 ± 2.35 vs 2.47 ± 1.02, p < 0.05). Main independent predictors of CI-AKI were anemia (OR 2.42; 95% CI 1.43–4.09; p < 0.05), main left coronary artery disease (OR 2.29; 95% CI 1.35–3.89; p < 0.001), DM (OR 1.82; 95% CI 1.05–3.17; p < 0.05). Patients with CI-AKI had higher risk of 30-days mortality (11 vs 4%, p < 0.05) and similar rate of 6 months rehospitalizations (63 vs 48%, p < 0.05). Conclusions: CI-AKI was associated with higher rate of comorbidities (DM, anemia), higher baseline serum creatinine and WBC, main left coronary artery disease. CI-AKI had negative impact on 30-days mortality and 6 months rehospitalizations.