Analysis of Biomarkers for Risk of Acute Kidney Injury After Primary Angioplasty for Acute ST-Segment Elevation Myocardial Infarction: Results of the HORIZONS-AMI Trial/Guerchicoff et al./2015/United States of America/Catheter Cardiovasc Interv(1818 Guerchicoff A, Stone GW, Mehran R, Xu K, Nichols D, Claessen BE, et al. Analysis of biomarkers for risk of acute kidney injury after primary angioplasty for acute ST-segment elevation myocardial infarction: Results of the HORIZONS-AMI trial. Catheter Cardiovasc Interv. 2015;85(3):335-42. doi: 10.1002/ccd.25620 https://doi.org/10.1002/ccd.25620...
). |
Cohort/Level 4. |
To analyze whether contrast-induced acute kidney injury (AKI) can occur after percutaneous coronary intervention. |
Analyzing 390 patients 14.3% developed CIN In this group, the levels of type B natriuretic peptide were higher than in the group without AKI at the beginning of the study (P <0.03), hospital discharge (P <0.001), follow-up 30 days (P <0.01) and 1 year follow-up (P <0.03). At hospital discharge, there was an increase in D-dimer (P <0.01), C-reactive protein (P <0.04), selective adhesion molecule of endothelial cells (P <0.01), adiponectin (P <0.03) and von Willebrand factor (P <0.01), compared to the group without AKI. |
The risk of CIN after primary percutaneous coronary intervention for acute myocardial infarction with ST-segment elevation may be associated with hemostatic imbalances, activation of pro coagulants, decreased endogenous anticoagulants, inflammation, platelet activation or reduced fibrinolytic activity. |
Contrast-induced nephropathy after primary angioplasty for acute myocardial infarction/Santos et al./2015/Brazil/ J Bras Nefrol(1919 Santos P, Carneiro Neto J, Arcanjo F, Carneiro J, Carneiro R, Amaral C. Contrast-induced nephropathy after primary angioplasty for acute myocardial infarction. J Bras Nefrol. 2015;37(4):439-45. doi: 10.5935/0101-2800.20150070 https://doi.org/10.5935/0101-2800.201500...
). |
Cohort/Level 4. |
To determine the incidence and factors associated with CIN in patients with acute myocardial infarction undergoing angioplasty in the first 12 hours after the onset of symptoms. |
The total sample was 201 patients. CIN incidence was 23.8%. In the univariate analysis, patients with CIN were older and with a higher frequency of left ventricular ejection fraction=40% and Killip classification=2. |
CIN affects a quarter of patients with acute myocardial infarction undergoing angioplasty without predictive variables. |
One-year results of the ICON (Ionic versus non-Ionic Contrast to Obviate worsening Nephropathy after angioplasty in chronic renal failure patients) Study/Giustino et al./ 2016/United States of America/J Catheter Cardiovasc Interv(2020 Giustino G, Baber U, Mastoris I, Vlachojannis GJ, Yu J, Teirstein P, et al. One-year results of the ICON (ionic versus non-ionic contrast to obviate worsening nephropathy after angioplasty in chronic renal failure patients) Study. Catheter Cardiovasc Interv. 2016;87(4):703-709. doi: 10.1002/ccd.26106 https://doi.org/10.1002/ccd.26106...
). |
Randomized, double-blind, multicenter clinical trial/ Level 2. |
To assess differences in mortality, acute myocardial infarction or PCI, at 1 year after exposure to non-ionic iso-osmolar contrast medium (IOCM) or low-osmolar ion contrast medium (LOCM) in patients with chronic kidney disease undergoing angiography coronary. |
The total sample was 146 patients. In 1 year, three deaths (4.1%) occurred in the LOCM group and nine deaths in the IOCM group (13.6%, P <0.07). The 1-year cardiac mortality rate was 2.7% in the LOCM group and 9.1% in the IOCM group (P <0.07). There were no significant differences in the rates of myocardial infarction (1.4% vs. 1.5%; P=1.00) and repeated revascularization (6.8% vs. 9.1%; P=0.75). |
Using ionic ioxaglate (LOCM) has been associated with numerically lower mortality in 1 year compared to iodixanol (IOCM) in patients undergoing cardiac catheterization. |
Off-Hour Primary Percutaneous Coronary Angioplasty Does Not Affect Contrast Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction/Velibey et al./2017/Turkey/J Angiology(2121 Velibey Y, Tanik O, Oz A, Guvenc TS, Kalenderoglu K, Gumusdag A, et al. Off-Hour Primary Percutaneous Coronary Angioplasty Does Not Affect Contrast-Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction. Angiology. 2017;68(9):807-815. doi: 10.1177/0003319717692285 https://doi.org/10.1177/0003319717692285...
). |
Retrospective control case/Level 6. |
To assess whether primary PCI outside working hours (weekdays from 17:01 to 19:00) is related to an increased incidence of CIN. |
The total sample was 2556 patients. The group outside working hours was more often admitted with acute symptoms of heart failure (16.4% vs 7.8%, P <0.001) and more contrast was injected (235.2 ± 82.3 vs 248.9 ± 87.1 ml, P <0.002). There was a trend towards higher hospital mortality when PCI was performed outside working hours (1.9% vs 0.7%, P=0.081). There was no significance with increased risk for CIN (Odds Ratio: 1.051, P=0.833). |
CIN incidence did not increase during non-working hours, and PCI outside working hours is not a risk factor for CIN, despite an apparent increase in the use of contrast medium during off-hour PCI. |
Preventive effect of statin pretreatment on contrast-induced acute kidney injury in patients undergoing coronary angioplasty propensity score analysis from a multicenter registry/Hoshi et al./2014/Japan/Int J Cardiol(2222 Hoshi T, Sato A, Kakefuda Y, Harunari T, Watabe H, Ojima E, et al. Preventive effect of statin pretreatment on contrast-induced acute kidney injury in patients undergoing coronary angioplasty: propensity score analysis from a multicenter registry. Int J Cardiol. 2014;171(2):243-9. doi: 10.1016/j.ijcard.2013.12.017 https://doi.org/10.1016/j.ijcard.2013.12...
). |
Retrospective and multicenter control case/ Level 6. |
To investigate whether statin pretreatment prevents CIN in patients with coronary artery disease undergoing PCI. |
Of 2,198 patients, a total of 8.7% developed CIN. In the propensity-resected groups, the incidence of CIN was significantly lower in patients with pretreatment with statin than in those without pretreatment (3.5% vs. 10.6%, odds ratio [OR]: 0.31, 95% confidence interval (P <0.001). Multivariate logistic regression analysis showed that the pre-treatment group remained a negative predictor independent of CIN (OR: 0.31, 95% CI, P <0.001) among subjects with propensity. |
Pre-treatment with statin has been associated with a significant decrease in the risk of CIN in patients with coronary artery disease undergoing PCI. |