稳定冠状动脉疾病患者造影剂肾病及1年预后

O. Mironov, O. Sivakova, V. Fomin
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摘要

的目标。本研究的目的是评估慢性冠状动脉疾病(CAD)患者造影剂肾病(CIN)的患病率及其1年预后意义。材料和方法。本研究纳入462例慢性CAD患者及动脉内造影剂干预适应症。我们进行了一项前瞻性开放队列研究(ClinicalTrials.gov NCT04014153)。主要终点是CIN的发展。次要终点为总死亡率、心血管死亡率、心肌梗死、脑卒中、胃肠道出血、心力衰竭急性失代偿、冠状动脉旁路移植术、重复经皮冠状动脉介入治疗。28例(6%)发生CIN。女性患者的CIN发生率是男性的2倍(9.29% vs. 4.66%)。非肥胖患者的CIN病例有减少的趋势(5.88% vs. 6.22%)。贫血患者发生CIN的频率更高(8.9% vs 5.7%, r =0,3649, ОR 1,633,95% CI 0,6507-4,239)。高尿酸血症患者的CIN发生率有升高的趋势(8% vs. 5,95%, r =0,6575, ОR 1,375,95% CI 0,3055-5,808)。糖尿病患者CIN发生率比无糖尿病患者高2%。随访1年后发生心肌梗死的患者CIN发生率最高(26.7%),其他主要心血管并发症患者CIN发生率最高(18.1%)。经皮冠状动脉介入治疗的重复率为9.5%,急性心力衰竭失代偿率为7%。慢性CAD患者中CIN的发生率为6%。随访1年后,心肌梗死、多次经皮冠状动脉介入治疗和心力衰竭急性失代偿的患者CIN发生率较高。
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CONTRAST-INDUCED NEPHROPATHY IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE AND 1-YEAR PROGNOSIS
Aim.The aim of our study was to assess the prevalence of contrast-induced nephropathy (CIN) in patients with chronic coronary artery disease (CAD) and its 1-year prognostic significance.Materials and methods.462 patients with chronic CAD and indications to the interventions with intraarterial contrast media administration were included in the study. We conducted a prospective open cohort study (ClinicalTrials.gov NCT04014153). The primary endpoint was the development of CIN. The secondary endpoints were total mortality, cardiovascular mortality, myocardial infarction, stroke, gastrointestinal bleeding, acute decompensation of heart failure, coronary artery bypass grafting, repeat percutaneous coronary intervention.Results.28 patients (6%) developed CIN. The rate of CIN in female patients was twice higher, than in males (9,29% vs. 4,66%). There was a trend towards less cases of CIN in patients without obesity (5,88% vs. 6,22%). CIN developed more frequently in patients with anemia (8,9% и 5,7%, р=0,3649, ОR 1,633,95% CI 0,6507-4,239). There was a trend to higher incidence of CIN in people with hyperuricemia (8% vs. 5,95%, р=0,6575, ОR 1,375,95% CI 0,3055-5,808). The rate of CIN in patients with diabetes mellitus was 2% higher, then without one. People, who suffered from myocardial infarction after 1 year of follow up, had the highest rate of CIN (26,7%), as well as patients with other major cardiovascular complications (18,1%). The rate of repeat percutaneous coronary interventions was 9,5%, the rate of acute decompensation of heart failure was 7%.Conclusion.The prevalence of CIN in patients with chronic CAD was 6%. After 1 year of follow up the rate of CIN was higher in patients who had myocardial infarction, repeat percutaneous coronary interventions and acute decompensation of heart failure.
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