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Contrast-Induced Nephropathy in Coronary Angiography and Intervention

C. Chao,Vincent Wu,Yen-Hung Lin

Published 2013 in Unknown venue

ABSTRACT

Since the advent of coronary angioplasty more than 3 decades ago, the volume of percutane‐ ous coronary interventions (PCI) has been rising progressively, with relative decrease in amount of coronary artery bypass graft (CABG) surgery. Roughly 1.4 million of catheteriza‐ tion procedures are performed in U.S. each year.[1] Contrast medium is widely used in both diagnositc coronary angiography and PCI, and intravenous use of iodinated contrast medi‐ um is a common precipitator of contrast-induced nephropathy (or contrast-induced acute kidney injury [AKI]). [2, 3] With the trend of increasing PCI use in the modern era, expected‐ ly more patients will develop contrast-induced AKI in the future. Currently contrast-in‐ duced nephropathy has been the third most common cause of hospital-acquired AKI in the large registry studies. [4] This phenomenon is worthy of our attention, since past researchers have identified that contrast-induced AKI can be associated with increased late incidence of acute myocardial infarction (AMI) and target vessel revascularization [5], longer in-hospital stay [6], a more complicated hospitalization course (bleeding episodes requiring transfusion, vascular complications) [7], and higher in-hospital mortality and morbidity [8-10]. More im‐ portantly, contrast induced AKI correlates with higher healthcare resource utilization in‐ cluding hospitalization cost [11]. The economical spending increases even further if the episodes of contrast-induced AKI are dialysis-requring.

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