Impact of femoral or radial approach on acute renal injury induced by repeated contrast medium in patients with coronary heart disease.
10.3760/cma.j.cn112148-20201105-00882
- Author:
Peng LI
1
;
Yi KANG
2
;
Zhao Feng WANG
1
;
Chong Huai GU
3
;
Guan Nan AI
1
;
Yi Fei LIU
1
;
Pei XU
1
;
Xiao Zeng WANG
1
;
Xin ZHAO
1
;
Ya Ling HAN
1
Author Information
1. Department of Cardiology, General Hospital of Northern Theater Command, Cardiovascular Research Institute of PLA, Shenyang 110016, China.
2. Heart Center, First Affiliated Hospital of Tsinghua University, Beijing 100000, China.
3. Department of Cardiology, Anqing Affiliated Hospital of Anhui Medical University, Anqing 246000, China.
- Publication Type:Journal Article
- Keywords:
Contrast-induced acute kidney injury;
Coronary artery disease;
Femoral artery approach;
Percutaneous coronary intervention;
Radial artery approach
- MeSH:
Acute Kidney Injury/epidemiology*;
Contrast Media/adverse effects*;
Coronary Disease;
Femoral Artery/surgery*;
Humans;
Incidence;
Percutaneous Coronary Intervention/adverse effects*;
Radial Artery;
Retrospective Studies;
Risk Factors
- From:
Chinese Journal of Cardiology
2020;48(12):1053-1059
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the effects of femoral approach versus radial approach on the incidence of contrast-induced acute kidney injury (CI-AKI) in patients with coronary heart disease, who received twice contrast agents within a short interval. Methods: A total of 322 patients with coronary heart disease, who admitted to the General Hospital of Northern Theater Command from January 2010 to January 2015, were included in this retrospective analysis. All patients exposed to contrast agents twice within 30 days. The patients were divided into two groups according to the approach of interventional operation: radial artery group (n=235) and femoral artery group (n=87). Serum creatinine (SCr) values were detected at 48 and 72 hours post procedure. Endpoint events were CI-AKI, which was defined as SCr increased>0.5 mg/dl (44.2 μmol/L) or relative ratio ((postoperative SCr-preoperative SCr)/preoperative SCr×100%>25%) within 72 hours after contrast agent use after excluding other causes. Clinical characteristics and the incidence of CI-AKI were compared between the two groups, multivariate logistic regression analysis was used to detect the risk factors of postoperative CI-AKI in these patients. Results: The proportion of smoking, PCI history, STEMI patients and levels of fibrinogen, fasting blood glucose, troponin T was significantly higher in femoral artery group than in radial artery group (all P<0.05). The interval between two procedure sessions was significantly longer in the femoral artery group than in the radial artery group (P=0.001). The incidence of CI-AKI tended to be higher in femoral artery group than in radial artery group after the first operation (18.6% (16/87) vs. 11.9% (28/235), P=0.133). CI-AKI incidence after the second operation was similar between the two groups (P>0.05). Multivariate logistic regression analysis showed that interventional approach was not an independent risk factor for postoperative CI-AKI in patients with coronary heart disease undergoing interventional procedures twice within 30 days (P>0.05);STEMI (OR=2.854, 95%CI 1.100-7.404, P=0.031) and diuretics use (OR=4.002, 95%CI 1.470-10.893, P=0.007) were independent risk factors for CI-AKI after the first operation. Conclusion: There is no correlation between the risk of CI-AKI and interventional approaches in patients with coronary heart disease who undergo interventional surgery twice within 30 days.
