title: Use of the contrast volume or grams of iodine-to-creatinine clearance ratio to predict mortality after percutaneous coronary intervention.
abstract: BACKGROUND
  Few studies have assessed the predictive value of the ratio of the contrast media volume or grams of iodine to the creatinine clearance (V/CrCl or g-I/CrCl, respectively) for the risk of contrast-induced nephropathy (CIN) and mortality after percutaneous coronary intervention (PCI).
  
  
  METHODS
  The association between V/CrCl and mortality was prospectively evaluated in 1,135 consecutive patients undergoing PCI. Cox regression models were used to adjust for the V/CrCl ratio and other confounding factors for risk of death within 1 year.
  
  
  RESULTS
  Fifty-five patients (4.84%) developed CIN. The 1-year mortality was higher in patients with a V/CrCl ratio >2.62 (g-I/CrCl >0.97) than in others (4.44% vs 0.40%; P < .001). After adjusting for other risk factors, the 1-year mortality risk remained associated with increased V/CrCl ratio. The risk of death was significant for V/CrCl >2.62 (adjusted risk ratio [RR] for death 2.605, 95% CI 1.040-6.529, P = .041), V/CrCl >3.0 (g-I/CrCl >1.11) (adjusted RR 4.338, 95% CI 1.689-11.142, P = .002), and V/CrCl >3.7 (g-I/CrCl >1.37) (adjusted RR 2.557, 95% CI 1.162-5.627, P = .002).
  
  
  CONCLUSIONS
  The data further support the prognostic significance of calculating the V/CrCl ratio to predict the relative maximum contrast volume during PCI. Use of a contrast dose determined based on the estimated renal function with a planned V/CrCl ratio <3.7 (g-I/CrCl <1.37) and preferably <2.62 (g-I/CrCl <0.97) might be valuable in reducing the risks of CIN and even death after PCI.
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Tan
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Ji-Yan
authors.initials: JY
authors.lastname: Chen
authors.forename: Ying-Ling
authors.initials: YL
authors.lastname: Zhou
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.forename: Li-Wen
authors.initials: LW
authors.lastname: Li
authors.forename: Dan-Qing
authors.initials: DQ
authors.lastname: Yu
authors.forename: Zhu-Jun
authors.initials: ZJ
authors.lastname: Chen
authors.forename: Xiao-Qi
authors.initials: XQ
authors.lastname: Liu
authors.forename: Shui-Jin
authors.initials: SJ
authors.lastname: Huang
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007455:Iodine / Q000008:administration & dosage; D007674:Kidney Diseases / Q000139:chemically induced*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D007455:Iodine; D003404:Creatinine