Document Detail


Clinical impact of nephropathy induced by contrast medium in patients with acute myocardial infarction undergoing emergent coronary angiography
MedLine Citation:
PMID:  16886495     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The incidence of contrast-induced nephropathy (CIN) after coronary angiography and the prognostic value in patients with acute myocardial infarction remains to be determined. This study investigated the frequency, predictors of CIN, and the prognostic significance of CIN in acute myocardial infarction patients undergoing emergent coronary angiography. METHODS: This study included 132 consecutive acute myocardial infarction patients undergoing emergent coronary angiography within 24 hr after the onset between January 1999 and June 2001. The serum creatinine concentration was measured on admission and at 48 hr after contrast medium exposure. CIN was defined as an increase in serum creatinine from the baseline > or = 0.5 mg/dl or > or = 25% at 48 hr after emergent coronary angiography. The patient characteristics, and in-hospital and long-term mortality were compared between the CIN and non-CIN groups. RESULTS: CIN occurred in 15 patients (11.4%) after emergent coronary angiography. The predictor of CIN development was preexisting renal impairment (serum creatinine concentration > or = 1.2 mg/dl on presentation; 21.9% vs 8.0%, odds ratio 3.22, 95% confidence interval 1.07-9.74, p = 0.04). In-hospital mortality was significantly higher in the CIN group than in the non-CIN group (13.3% vs 1.7%; odds ratio 8.85, 95% confidence interval 1.15-68.2, p = 0.01). The long-term mortality (mean follow-up period of 40 months) was also higher in the CIN group (26.7% vs 8.6%; hazard ratio 3.91, 95% confidence interval 1.21-12.5, p = 0.02). CONCLUSIONS: CIN was an independent predictor of both in-hospital and long-term mortality in acute myocardial infarction patients undergoing emergent coronary angiography. Preexisting renal insufficiency was associated with subsequent CIN.
Authors:
Kentaro Jujo; Junichi Yamaguchi; Kenji Obayashi; Kaori Suzuki; Haruki Sekiguchi; Michitaka Nagashima; Yukio Tsurumi; Hiroshi Kasanuki
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  Journal of cardiology     Volume:  48     ISSN:  0914-5087     ISO Abbreviation:  J Cardiol     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-08-04     Completed Date:  2006-08-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  Japan    
Other Details:
Languages:  jpn     Pagination:  9-16     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Tokyo Women's Medical University, Kawada-cho 8-1, Shinjuku-ku, Tokyo 162-8666. juken1123@hotmail.co.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Contrast Media / adverse effects*
Coronary Angiography / adverse effects*
Creatinine / blood
Emergencies
Female
Hospital Mortality
Humans
Iopamidol / adverse effects*
Kidney Diseases / chemically induced*
Male
Middle Aged
Myocardial Infarction / mortality,  radiography*
Predictive Value of Tests
Prognosis
Chemical
Reg. No./Substance:
0/Contrast Media; 60-27-5/Creatinine; 62883-00-5/Iopamidol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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