Abstract: Poster Presentations |


Arvind Goel, MD*; Wilbert S. Aronow, MD; Hoang M. Lai, MD; Savneek S. Chugh, MD; Basudev Pudasaini, MD; Andrew H. Gutwein, MD
Author and Funding Information

New York Medical College, Valhalla, NY


Chest. 2009;136(4_MeetingAbstracts):107S. doi:10.1378/chest.136.4_MeetingAbstracts.107S
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PURPOSE:  To investigate the incidence of contrast-induced nephropathy (CIN) after coronary angiography, treatment regimens for CIN, and clinical outcomes.

METHODS:  We investigated in patients who underwent coronary angiography during 2005–2008 the incidence of CIN. CIN was defined as > 25% increase in serum creatinine or an increase in serum creatinine of 0.5 mg/dl or more within 48 hours after coronary angiography. Charts of patients who developed CIN were reviewed for demographics, treatment regimens, and in-hospital complications and mortality.

RESULTS:  Of 13,742 patients, 80 (0.6%) developed CIN. The 80 patients included 46 men and 34 women, mean age 69 years. Of 80 patients, 63 (79%) had hypertension, 60 (75%) had obstructive coronary disease, 51 (64%) had heart failure, 47 (59%) had dyslipidemia, 44 (55%) had diabetes, 28 (35%) had anemia, 19 (24%) had recent anterior myocardial infarction, and 17 (21%) had hemodynamic instability with shock at admission. Of 80 patients, 43 (54%) were treated with saline alone, 27 (34%) with N-acetylcysteine (NAC) alone, 6 (8%) with saline plus NAC,and 4 (5%) with sodium bicarbonate. In hospital mortality occurred in 18 of 80 patients (23%) with CIN, in 11 of 43 (26%) treated with saline alone, in 4 of 27 (15%) treated with NAC alone, in 2 of 4 (50%) treated with sodium bicarbonate, and in 1 of 6 patients (17%) treated with saline plus NAC (p not significant). In-hospital hemodialysis occurred in 22 of 80 patients (28%), in none of 6 (0%) treated with saline plus NAC (a), in 15 of 43 (35%) treated with saline alone (b), in 3 of 4 (75%) treated with sodium bicarbonate (c), and in 4 of 27 (15%) treated with NAC alone (d) (p < 0.05 comparing c with a and c with d).

CONCLUSION:  The incidence of CIN after coronary angiography was 0.6%. In-hospital mortality was 23%, and 28% required hemodialysis.

CLINICAL IMPLICATIONS:  CIN occurs in 0.6% of patients after coronary angiography, was associated with a 23% in-hospital mortality, and required hemodialysis in 28% of patients.

DISCLOSURE:  Arvind Goel, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, November 4, 2009

12:45 PM - 2:00 PM




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