Department of Cardiology, the Second Hospital of Hebei Medical University and the Institute of Cardiocerebrovascular Disease of Hebei Province, Shijiazhuang, 050000, China.
BMC Cardiovasc Disord. 2023 Jun 24;23(1):323. doi: 10.1186/s12872-023-03358-w.
Hydration is currently the main measure to prevent contrast-induced nephropathy (CIN). We aimed to compare the preventive effect of preprocedure and postprocedure hydration on CIN in patients with coronary heart disease undergoing elective percutaneous coronary intervention (PCI).
A retrospective study included 198 cases of postprocedure hydration and 396 cases of preprocedure hydration using propensity score matching. The incidence of CIN 48 h after PCI and adverse events within 30 days after contrast media exposure were compared between the two groups. Logistic regression analysis was used to analyse the risk factors for CIN.
The incidence of CIN in the postprocedure hydration group was 3.54%, while that in the preprocedure hydration group was 4.8%. There was no significant difference between the two groups (p = 0.478). Multivariate logistic regression analysis showed that diabetes mellitus, baseline BNP and cystatin C levels, and contrast agent dosage were independent risk factors for CIN. There was no significant difference in the incidence of major adverse events between the two groups (3.03% vs. 2.02%, p = 0.830).
Postprocedure hydration is equally effective compared to preoperative hydration in the prevention of CIN in patients with coronary heart disease undergoing elective PCI.
水化目前是预防对比剂肾病（CIN）的主要措施。我们旨在比较择期经皮冠状动脉介入治疗（PCI）前和后水化对冠心病患者 CIN 的预防效果。
回顾性研究纳入了 198 例术后水化和 396 例术前水化的患者，采用倾向评分匹配。比较两组患者 PCI 后 48 小时 CIN 的发生率和造影剂暴露后 30 天内的不良事件。采用 logistic 回归分析 CIN 的危险因素。
术后水化组 CIN 的发生率为 3.54%，而术前水化组为 4.8%。两组间无显著差异（p = 0.478）。多因素 logistic 回归分析显示，糖尿病、基线 BNP 和胱抑素 C 水平以及造影剂剂量是 CIN 的独立危险因素。两组间主要不良事件的发生率无显著差异（3.03%比 2.02%，p = 0.830）。
对于择期 PCI 的冠心病患者，术后水化与术前水化预防 CIN 的效果相当。
