Impact of gender on the incidence and outcome of contrast-induced nephropathy after percutaneous coronary intervention.
BACKGROUND
Contrast-induced nephropathy (CIN) is a recognized complication after percutaneous interventions (PCI). We sought to determine the impact of gender on incidence and clinical outcome of CIN.


RESULTS
Of a total 8,628 patients who underwent PCI, there were 1,431 (16.5%) who developed CIN (defined as > 25% rise in creatinine after PCI). Patients were followed clinically for one year. CIN was present in 23.6% of female versus 17.4% of male patients (p < 0.0001). Multivariate analysis showed that female gender (OR = 1.4, 95% CI = 1.25 1.60; p < 0.0001), pre-PCI chronic renal failure (CRF) (OR= 1.8, 95% CI = 1.53 2.10, p < 0.0001), diabetes mellitus (OR = 1.5, 95% CI = 1.34 1.70; p < 0.0001), age (OR = 1.01, 95% CI = 1.01 1.02, p < 0.0001), and hypertension (OR = 1.2, 95% CI = 1.06 1.36, p = 0.0035) were independent predictors of CIN. Clinical outcomes after CIN were examined in patients with or without CRF. Among patients without CRF who developed CIN, females (n = 465) had higher rates of one-year mortality, and MACE comparing to males (n = 710) without CRF (14% vs. 10% mortality, 36% vs. 30% MACE; p = 0.05 and 0.06, respectively). In patients with CRF who developed CIN, we found no significant gender differences in one-year clinical events (37% vs. 36% mortality, 42% vs. 45% MACE; p = 0.8 and 0.6, respectively). By multivariate analysis only baseline CRF, diabetes, age, functional NYHA IV class were identified as independent predictors of one-year mortality in patients with CIN after PCI.


CONCLUSIONS
Female gender is an independent predictor of CIN development after PCI and a marker of worse 1-year mortality after CIN in patients without baseline CRF. After CIN is developed, pre-PCI CRF, diabetes mellitus, age, severe heart failure (not gender) are independent predictors of one-year mortality.
Iakovou
Ioannis
I
Lenox Hill Heart and Vascular Institute and Cardiovascular Research Foundation, 55 East 59th Street, 6th Floor, New York, NY, 10022, USA. gdangas@crf.org
Dangas
George
G
Mehran
Roxana
R
Lansky
Alexandra J
AJ
Ashby
Dale T
DT
Fahy
Martin
M
Mintz
Gary S
GS
Kent
Kenneth M
KM
Pichard
Augusto D
AD
Satler
Lowell F
LF
Stone
Gregg W
GW
Leon
Martin B
MB
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017073:Atherectomy; D003287:Contrast Media / Q000009:adverse effects*; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015641:Radiography, Interventional; D012737:Sex Factors; D015607:Stents
D003287:Contrast Media