Low ejection fraction predisposes to contrast-Induced nephropathy after the second step of staged coronary revascularization for acute myocardial infarction : a retrospective observational study

2020
journal article
article
6
cris.lastimport.wos2024-04-09T23:19:28Z
dc.abstract.enPatients who develop contrast-induced nephropathy (CIN) are at an increased short-term and long-term risk of adverse cardiovascular (CV) events. Our aim was to search for patient characteristics associated with changes in serum creatinine and CIN incidence after each step of two-stage coronary revascularization in patients with acute myocardial infarction (AMI) and multivessel coronary artery disease undergoing staged coronary angioplasty during hospitalization for AMI. We retrospectively analyzed medical records of 138 patients with acute myocardial infarction without hemodynamic instability, in whom two-stage coronary angioplasty was performed during the initial hospital stay. In-hospital serum creatinine levels were recorded before the 1st intervention (at admission), within 72 h after the 1st intervention (before the 2nd intervention), and within 72 h after the 2nd intervention. The incidence of CIN was 2% after the 1st intervention (i.e., primary angioplasty) and 8% after the 2nd intervention. Patients with significant left ventricular systolic dysfunction after the 1st intervention (ejection fraction (EF) ≤35%) exhibited higher relative rises in creatinine levels after the 2nd intervention (18 ± 29% vs. 2 ± 16% for EF ≤35% and >35%, respectively, p = 0.03), while respective creatinine changes after the 1st revascularization procedure were comparable (−1 ± 14% vs. 2 ± 13%, p = 0.4). CIN after the 2nd intervention was over five-fold more frequent in subjects with low EF (28% vs. 5%, p = 0.007). The association between low EF and CIN incidence or relative creatinine changes after the 2nd intervention was maintained upon adjustment for baseline renal function, major CV risk factors, and the use of renin-angiotensin axis antagonists prior to admission. In conclusion, low EF predisposes to CIN after second contrast exposure in patients undergoing two-stage coronary angioplasty during the initial hospitalization for AMI. Our findings suggest a need of extended preventive measures against CIN or even postponement of second coronary intervention in patients with significant left ventricular dysfunction scheduled for the second step of staged angioplasty. View Full-Textpl
dc.affiliationWydział Lekarski : Instytut Kardiologiipl
dc.cm.date2020-12-02
dc.cm.id100007
dc.contributor.authorChyrchel, Michał - 357068 pl
dc.contributor.authorHałubiec, Przemysławpl
dc.contributor.authorŁazarczyk, Agnieszkapl
dc.contributor.authorDuchnevic, Olgerdpl
dc.contributor.authorOkarski, Michałpl
dc.contributor.authorGębska, Monikapl
dc.contributor.authorSurdacki, Andrzej - 133538 pl
dc.date.accession2020-07-14pl
dc.date.accessioned2020-12-02T10:30:39Zpl
dc.date.available2020-12-02T10:30:39Zpl
dc.date.issued2020pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number6pl
dc.description.points140pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume9pl
dc.identifier.articleid1812pl
dc.identifier.doi10.3390/jcm9061812pl
dc.identifier.eissn2077-0383pl
dc.identifier.projectROD UJ / OPpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/257889
dc.identifier.weblinkhttps://www.mdpi.com/2077-0383/9/6/1812pl
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa 4.0 Międzynarodowa*
dc.rights.licenceCC-BY
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/legalcode.pl*
dc.share.typeotwarte czasopismo
dc.subject.encontrast-induced nephropathypl
dc.subject.enacute myocardial infarctionpl
dc.subject.enstaged coronary revascularizationpl
dc.subject.enejection fractionpl
dc.subtypeArticlepl
dc.titleLow ejection fraction predisposes to contrast-Induced nephropathy after the second step of staged coronary revascularization for acute myocardial infarction : a retrospective observational studypl
dc.title.journalJournal of Clinical Medicinepl
dc.typeJournalArticlepl
dspace.entity.typePublication
cris.lastimport.wos
2024-04-09T23:19:28Z
dc.abstract.enpl
Patients who develop contrast-induced nephropathy (CIN) are at an increased short-term and long-term risk of adverse cardiovascular (CV) events. Our aim was to search for patient characteristics associated with changes in serum creatinine and CIN incidence after each step of two-stage coronary revascularization in patients with acute myocardial infarction (AMI) and multivessel coronary artery disease undergoing staged coronary angioplasty during hospitalization for AMI. We retrospectively analyzed medical records of 138 patients with acute myocardial infarction without hemodynamic instability, in whom two-stage coronary angioplasty was performed during the initial hospital stay. In-hospital serum creatinine levels were recorded before the 1st intervention (at admission), within 72 h after the 1st intervention (before the 2nd intervention), and within 72 h after the 2nd intervention. The incidence of CIN was 2% after the 1st intervention (i.e., primary angioplasty) and 8% after the 2nd intervention. Patients with significant left ventricular systolic dysfunction after the 1st intervention (ejection fraction (EF) ≤35%) exhibited higher relative rises in creatinine levels after the 2nd intervention (18 ± 29% vs. 2 ± 16% for EF ≤35% and >35%, respectively, p = 0.03), while respective creatinine changes after the 1st revascularization procedure were comparable (−1 ± 14% vs. 2 ± 13%, p = 0.4). CIN after the 2nd intervention was over five-fold more frequent in subjects with low EF (28% vs. 5%, p = 0.007). The association between low EF and CIN incidence or relative creatinine changes after the 2nd intervention was maintained upon adjustment for baseline renal function, major CV risk factors, and the use of renin-angiotensin axis antagonists prior to admission. In conclusion, low EF predisposes to CIN after second contrast exposure in patients undergoing two-stage coronary angioplasty during the initial hospitalization for AMI. Our findings suggest a need of extended preventive measures against CIN or even postponement of second coronary intervention in patients with significant left ventricular dysfunction scheduled for the second step of staged angioplasty. View Full-Text
dc.affiliationpl
Wydział Lekarski : Instytut Kardiologii
dc.cm.date
2020-12-02
dc.cm.id
100007
dc.contributor.authorpl
Chyrchel, Michał - 357068
dc.contributor.authorpl
Hałubiec, Przemysław
dc.contributor.authorpl
Łazarczyk, Agnieszka
dc.contributor.authorpl
Duchnevic, Olgerd
dc.contributor.authorpl
Okarski, Michał
dc.contributor.authorpl
Gębska, Monika
dc.contributor.authorpl
Surdacki, Andrzej - 133538
dc.date.accessionpl
2020-07-14
dc.date.accessionedpl
2020-12-02T10:30:39Z
dc.date.availablepl
2020-12-02T10:30:39Z
dc.date.issuedpl
2020
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
6
dc.description.pointspl
140
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
9
dc.identifier.articleidpl
1812
dc.identifier.doipl
10.3390/jcm9061812
dc.identifier.eissnpl
2077-0383
dc.identifier.projectpl
ROD UJ / OP
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/257889
dc.identifier.weblinkpl
https://www.mdpi.com/2077-0383/9/6/1812
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa 4.0 Międzynarodowa
dc.rights.licence
CC-BY
dc.rights.uri*
http://creativecommons.org/licenses/by/4.0/legalcode.pl
dc.share.type
otwarte czasopismo
dc.subject.enpl
contrast-induced nephropathy
dc.subject.enpl
acute myocardial infarction
dc.subject.enpl
staged coronary revascularization
dc.subject.enpl
ejection fraction
dc.subtypepl
Article
dc.titlepl
Low ejection fraction predisposes to contrast-Induced nephropathy after the second step of staged coronary revascularization for acute myocardial infarction : a retrospective observational study
dc.title.journalpl
Journal of Clinical Medicine
dc.typepl
JournalArticle
dspace.entity.type
Publication

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