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慢性冠状动脉完全闭塞患者经皮冠状动脉介入治疗后对比剂肾病与长期死亡率的关系。

Relationship between contrast-induced nephropathy and long-term mortality after percutaneous coronary intervention in patients with chronic coronary total occlusion.

机构信息

Diyarbakir Gazi Yaşargil Training and Research Hospital, Department of Cardiology - Diyarbakır, Turkey.

Mardin Training and Research Hospital, Department of Cardiology - Mardin, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2022 Aug;68(8):1078-1083. doi: 10.1590/1806-9282.20220283.

DOI:10.1590/1806-9282.20220283
PMID:36000604
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9574976/
Abstract

OBJECTIVE

Intervention in chronic total occlusion lesions involves long procedure time, a serious contrast load, and complex procedures. In this study, we aimed to investigate mortality rate of patients who had procedural coronary angiography done for chronic total occlusion lesions in coronary angiography series and who developed contrast-induced nephropathy.

METHODS

A total of 218 patients with chronic total occlusion lesion in at least one coronary artery, from three different medical centers, who underwent procedural coronary angiography were recruited for the study. Patient population was divided into two groups: those who developed contrast-induced nephropathy and those who did not. Mortality due to all causes was investigated between both groups throughout a 100-month follow-up.

RESULTS

Mean age of patients with incidence of contrast-induced nephropathy was 66.7±11.8, and 23.8% of them were comprised by female. We found a significantly higher mortality in long-term follow-up in the patient group with contrast-induced nephropathy (42.9 vs. 57.1%, p=<0.001). According to Kaplan-Meier analysis performed additionally, survival during follow-up was significantly shorter in this group and, in logistic regression analysis, it was an independent predictor of mortality (OR 11.78; 95%CI 3.38-40.9).

CONCLUSION

We identified that the development of contrast-induced nephropathy is associated with long-term mortality. It might be possible to reduce adverse events with prophylactic approaches before the procedure and close follow-up of such patients after the procedure.

摘要

目的

慢性完全闭塞病变的介入治疗涉及较长的手术时间、严重的造影剂负荷和复杂的手术过程。本研究旨在探讨在冠状动脉造影系列中对慢性完全闭塞病变进行经皮冠状动脉造影术且发生造影剂肾病的患者的死亡率。

方法

共纳入来自三个不同医疗中心的至少一支冠状动脉存在慢性完全闭塞病变的 218 名患者进行研究。将患者分为两组:发生造影剂肾病组和未发生造影剂肾病组。在 100 个月的随访期间,比较两组患者的全因死亡率。

结果

发生造影剂肾病患者的平均年龄为 66.7±11.8 岁,其中 23.8%为女性。我们发现造影剂肾病组患者在长期随访中的死亡率显著更高(42.9%比 57.1%,p<0.001)。通过进一步进行 Kaplan-Meier 分析发现,该组患者的随访期间生存时间明显缩短,且在逻辑回归分析中,造影剂肾病是死亡率的独立预测因素(OR 11.78;95%CI 3.38-40.9)。

结论

我们发现造影剂肾病的发生与长期死亡率相关。通过术前预防性措施和术后对这些患者的密切随访,可能降低不良事件的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/465d/9574976/6441e8657f88/0104-4230-ramb-1806-9282-20220283-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/465d/9574976/6441e8657f88/0104-4230-ramb-1806-9282-20220283-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/465d/9574976/6441e8657f88/0104-4230-ramb-1806-9282-20220283-gf01.jpg

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