Drug Effects and Clinical Investigations for Contrast-Induced Nephropathy After Coronary Angiography or Percutaneous Coronary Intervention in Patients With Diabetes

作者：Zhang, Man-Man; Lv, Qian-Zhou^*; Li, Xiao-Ye

来源：American Journal of Therapeutics, 2017, 24(4): E423-E430.

DOI：10.1097/MJT.0000000000000325

• contrast-induced nephropathy
• drug effects
• clinical investigations
• coronary angiography
• percutaneous coronary intervention
• diabetes mellitus

The aim of the study was to investigate the risk factors of preprocedural laboratory investigations and drug effects to the incidence of contrast-induced nephropathy (CIN) in patients with diabetes who underwent coronary angiography or percutaneous coronary intervention and to assess the short-term safety. We retrospectively studied a total of 568 patients with diabetes who underwent coronary angiography or percutaneous coronary intervention from January, 2013 to January, 2014 in our hospital and compared the baseline clinical characteristics, especially the laboratory investigations and preprocedural drugs of those 2 groups (with CIN group and without CIN group), and half year follow-up. Overall, 53 (9.33%) patients were developed into CIN according to the definition of an increase of 25% from the baseline of serum creatinine concentration, supposing that on the basis of an increase of 44.2 mu mol/L, the incidence would be 0.88% (5/568). No significant differences were found between the 2 groups with respect to age, diabetes mellitus duration, operation type, contrast type and volume, left ventricular ejection fraction, and combined diseases including hypertension, myocardial infarction, Arrhythmia, etc. However, patients with CIN tended to be lighter in body weight (P = 0.027) and were more often female [odds ratio (OR) = 2.8, P<0.01], and also had a higher prevalence with acute coronary syndrome (OR = 5.1, P<0.01). On the contrary to most studies, the preprocedural serum creatinine in with CIN group in our study was lower than without CIN group (P<0.001). As for the preprocedural drugs, statins seemed could decrease the incidence of CIN (OR = 0.34, P<0.05), and the use of diuretics might increase the occurrence of CIN (OR = 2.62, P<0.05). As regard to the follow-up results, the hospitalization days and expense of with CIN group were significantly longer and higher than the without CIN group, but no significance was found between rehospitalization rate in half year. Preprocedural preventions are essential because there is no effective treatment for CIN our findings could be considered in clinical practice. There are many risk factors for CIN; it is necessary to distinguish the high-risk patients so as to carry out corresponding protection actions.

• 出版日期2017-7
• 单位复旦大学