3 years ago

Impact of Transient or Persistent Contrast-Induced Nephropathy on Long-Term Mortality after Elective Percutaneous Coronary Intervention

Contrast-induced nephropathy (CIN) is associated with increased long-term mortality. However, it is still controversial whether CIN is the cause of increased mortality or merely a marker of high-risk patients. The current study population included 5516 patients who underwent their first elective percutaneous coronary intervention (PCI) in the CREDO-Kyoto registry cohort-2. CIN was defined as an elevation in the peak serum creatinine (SCr) of ≥0.5 mg/dL from the baseline within 5 days after PCI. CIN, seen in 218 patients (4.0%), was independently associated with an increased long-term mortality risk (HR, 1.43; 95%CI, 1.11 to 1.83; p = 0.005). SCr data at 1 year (180 to 550 days) after PCI were available in 3986 patients, who were subdivided into persistent CIN (follow-up SCr elevation ≥0.5 mg/dL: N = 50 [1.3%]), transient CIN (follow-up SCr elevation <0.5 mg/dL: N = 90 [2.3%]), and non-CIN (N = 3846 [96.5%]). In the landmark analysis at 1 year after PCI, 524 patients (13.1%) died during a median follow-up of 1521 days. After adjustment for the 37 confounders, persistent CIN, but not transient CIN, was significantly correlated with a higher long-term mortality risk compared with non-CIN (HR, 1.84; 95%CI, 1.12 to 3.03; p = 0.02, and HR, 1.11; 95%CI, 0.71 to 1.76; p = 0.6, respectively). In conclusion, only persistent CIN was independently associated with increased long-term mortality.

Publisher URL: www.sciencedirect.com/science

DOI: S0002914917314558

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