Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.23/780
Título: Contrast-induced nephropathy after an acute coronary syndrome.
Autor: Gaspar, A
Nabais, S
Ribeiro, S
Rocha, S
Azevedo, P
Álvares-Pereira, M
Brandão, A
Correia, A
Palavras-chave: Angiografia Coronária/efeitos adversos
Síndrome Coronária Aguda
Doenças do Rim
Meios de Contraste/efeitos adversos
Data: 2009
Citação: ESC Congress 2009. 29 Aug 2009 - 02 Sep 2009 , Barcelona - Spain
Resumo: Purpose: Contrast-induced nephropathy (CIN) is a form of hospital-acquired acute renal failure that sometimes develops after giving iodinated radiocontrast agents. The growing number of patients who undergo coronary angiography and percutaneous revascularization after acute coronary syndrome (ACS) brought more relevance to this entity. It’s actually one of the most frequent forms of hospital-acquired acute renal failure. The purpose of this study was to define the predictors and prognostic value of CIN in a population of patients admitted with ACS. Methods: A total of 558 patients consecutively admitted with ACS and submitted to cardiac catheterization procedure, from January 2004 to April 2006, were reviewed. CIN was defined as impairment of renal function occurring within 48 hours after administration of contrast media and manifested by an absolute increase in the serum creatinine level of at least 0.5 mg/dL or by a relative increase of at least 25% over the baseline value (in the absence of another cause). The patients were classified in 2 groups according to the occurrence of CIN. The primary endpoint was in-hospital mortality. Results: Of the 558 patients reviewed, 5% (n=28) developed CIN. Patients with CIN were older (69.6 ± 10.5 vs 61.5 ± 11.7; p <0.001) and more often had diabetes mellitus (42.9% vs 24%; p=0.02) and renal insufficiency (48% vs 14.7%; p <0.001). There were no differences regarding ACS presentation (with or without elevation in the ST segment) and in-hospital medical treatment. Patients with CIN had higher in-hospital mortality (10.7% vs 0.6%; p <0.001). After adjustment for confounding variables by multivariate analysis (age, renal insufficiency, heart rate on admission, systolic blood pressure on admission and Killip class on admission), CIN remained an independent predictor of in-hospital mortality. Conclusions: CIN occurred in 5% of our patients admitted with ACS. Risk factors associated with CIN were advanced age, diabetes and pre-existing renal insufficiency. CIN was an independent predictor of in-hospital mortality.
Peer review: yes
URI: http://hdl.handle.net/10400.23/780
Aparece nas colecções:HB - CAR - Comunicações e Conferências

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