Volume‐to‐creatinine clearance ratio in patients undergoing coronary angiography with or without percutaneous coronary intervention: Implications of varying definitions of contrast‐induced nephropathy. Issue 6 (31st August 2013)

• Record Type: Journal Article
• Authors: Capodanno, Davide; Ministeri, Margherita; Cumbo, Silvia; Dalessandro, Veronica; Tamburino, Corrado
• Is Part Of: Catheterization and cardiovascular interventions. Volume 83:Issue 6(2014:May 01)
• Page Start: 907
• Page End: 912
• Publication Date: 2013-08-31
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25153
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25153-sec-0001" sec-type="section"> <title>Objectives</title> <p>Whether predicting the risk of early serum creatinine rise using the ratio of the volume of contrast media administered to the estimated creatinine clearance (V/CrCl) is applicable to the broader definition of contrast‐induced nephropathy (CIN) (≥0.5 mg/dL absolute and/or 25% relative increase from baseline serum creatinine) is unknown.</p> </sec> <sec id="ccd25153-sec-0002" sec-type="section"> <title>Background</title> <p>A V/CrCl ≥4 has been proven to predict the risk of ≥0.5 mg/dL postprocedural absolute rise in serum creatinine.</p> </sec> <sec id="ccd25153-sec-0003" sec-type="section"> <title>Methods</title> <p>A total of 722 patients undergoing coronary angiography ± percutaneous coronary intervention (PCI) between March 2011 and October 2011 with paired serum creatinine determinations at preprocedure and within 72‐hr postprocedure were analyzed. The V/CrCl ratio was calculated by dividing the volume of contrast received by the patient's creatinine clearance. CIN using different definitions was termed as CIN<sub>narrow</sub> (rise in serum creatinine ≥0.5 mg/dL) and CIN<sub>broad</sub> (rise in serum creatinine ≥0.5 mg/dL and/or ≥25% increase in baseline serum creatinine).</p> </sec> <sec id="ccd25153-sec-0004" sec-type="section"> <title>Results</title> <p>The mean age was 66 ± 11 years and the mean baseline serum creatinine was 1.1 ± 0.8 mg/dL. Patients with V/CrCl ≥4 were significantly older and more frequently underwent ad hoc PCI compared with those with V/CrCl <4. CIN<sub>narrow</sub> and CIN<sub>broad</sub> were observed in 13 versus 3% (<italic>P</italic> < 0.001) and 23 versus 11% (<italic>P</italic> < 0.001) of patients with or without V/CrCl ≥4, respectively. After statistical adjustment, a V/CrCl ratio ≥4 remained significantly associated with the risk of both CIN<sub>narrow</sub> [adjusted OR 3.5, 95% confidence intervals (95% CI) 1.7–7.3; <italic>P</italic> < 0.001] and CIN<sub>broad</sub> (adjusted OR 2.5, 95% 1.6–3.9; <italic>P</italic> < 0.001).</p> </sec> <sec id="ccd25153-sec-0005" sec-type="section"> <title>Conclusions</title> <p>A volume‐to‐creatinine clearance ratio ≥4 significantly predicts the risk of early postprocedural rise in serum creatinine regardless of the CIN definition adopted. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>