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Inverse correlation between left ventricular end-diastolic pressure and contrast-induced nephropathy in patients undergoing percutaneous coronary intervention

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Abstract

Background

There is a rising incidence of contrast-induced nephropathy (CIN), which is defined as either a 25% relative increase or an absolute increase of 0.5 mg/dL (44.2 µmol/L) in the serum creatinine (Scr) level at 48–72 h after administration of iodinated contrast media (CM). We investigated the relationship between left ventricular end-diastolic pressure (LVEDP) and CIN in patients undergoing percutaneous coronary intervention (PCI).

Methods

A total of 431 consecutive patients with coronary artery disease undergoing PCI were divided into four groups based on LVEDP quartile cut-off points. Enrolled patients were given continuous intravenous infusion of normal saline starting 4 h before PCI and lasting 24 h. At the end of hydration administration, 20 mg furosemide was slowly injected intravenously. Serum creatinine (Scr), creatinine clearance rate (Ccr), and glomerular filtration rate (GFR) were detected before and after PCI.

Results

There were significant differences in the incidences of CIN in the four groups: 10.25% in the Q1 group, 5.55% in the Q2 group, 5.31% in the Q3 group, and 1.06% in the Q4 group (P < 0.05). With increasing LVEDP, the incidence of CIN decreased significantly (OR 0.581, 95% CI 0.367–0.920). Received operating characteristic curve analysis of the predictive value of LVEDP for CIN produced area under the curve values was 0.641, with a sensitivity of 74.1% and specificity of 48%. The optimal LVEDP cut-off for the occurrence of CIN was 14.5 mmHg.

Conclusions

LVEDP correlated inversely with CIN in patients undergoing PCI.

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Authors and Affiliations

  1. Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215 Hepingxi Road, Shijiazhuang, 050000, Hebei, China

    Guoqiang Gu, Hanghang Xing, Yaqing Zhou & Wei Cui

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  1. Guoqiang Gu
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  2. Hanghang Xing
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  3. Yaqing Zhou
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  4. Wei Cui
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Correspondence to Wei Cui.

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The authors have declared that no conflict of interest exists.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the the Second Affiliated Hospital of Hebei Medical University, at which the studies were conducted (IRB Approval Number 2014031) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards, Ethics Committee approval has been obtained.

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Informed consent was obtained from all individual participants included in the study.

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Gu, G., Xing, H., Zhou, Y. et al. Inverse correlation between left ventricular end-diastolic pressure and contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. Clin Exp Nephrol 22, 808–814 (2018). https://doi.org/10.1007/s10157-017-1514-6

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  • DOI: https://doi.org/10.1007/s10157-017-1514-6

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