Short-term rosuvastatin therapy for prevention of contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease.
OBJECTIVE
This study sought to evaluate the safety and efficacy of rosuvastatin in preventing contrast-induced acute kidney injury (CI-AKI) in patients with diabetes mellitus (DM) and chronic kidney disease (CKD).


BACKGROUND
CI-AKI is an important complication after contrast medium injection. While small studies have shown positive results with statin therapy, the role of statin therapy in prevention of CI-AKI remains unknown.


METHODS
We randomized 2,998 patients with type 2 DM and concomitant CKD who were undergoing coronary/peripheral arterial angiography with or without percutaneous intervention to receive rosuvastatin, 10 mg/day (n = 1,498), for 5 days (2 days before, and 3 days after procedure) or standard-of-care (n = 1,500). Patients' renal function was assessed at baseline, 48 h, and 72 h after exposure to contrast medium. The primary endpoint of the study was the development of CI-AKI, which was defined as an increase in serum creatinine concentration ≥0.5 mg/dl (44.2 μmol/l) or 0.25% above baseline at 72 h after exposure to contrast medium.


RESULTS
Patients randomized to the rosuvastatin group had a significantly lower incidence of CI-AKI than controls (2.3% vs. 3.9%, respectively; p = 0.01). During 30 days' follow-up, the rate of worsening heart failure was significantly lower in the patients treated with rosuvastatin than that in the control group (2.6% vs. 4.3%, respectively; p = 0.02).


CONCLUSIONS
Rosuvastatin significantly reduced the risk of CI-AKI in patients with DM and CKD undergoing arterial contrast medium injection. (Rosuvastatin Prevent Contrast Induced Acute Kidney Injury in Patients With Diabetes [TRACK-D]; NCT00786136).
Department of Cardiology, Shenyang Northern Hospital, Shenyang, China. Electronic address: hanyl169@gmail.com.
Yaling
Y
Han
Department of Cardiology, WuHan Asia Heart Hospital, Wuhan, China.
Guoying
G
Zhu
Department of Cardiology, CangZhou Central Hospital, CangZhou, China.
Lixian
L
Han
Department of Cardiology, Changchun Central Hospital, Changchun, China.
Fengxia
F
Hou
Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
Weijian
W
Huang
Department of Cardiology, General Hospital of Armed Police Forces, Beijing, China.
Huiliang
H
Liu
Department of Cardiology, Lanzhou Military WuluMuqi PLA Hospital, Wulumuqi, China.
Jihong
J
Gan
Department of Cardiology, Affiliated Hospital of Medical College of Armed Police Forces, Tianjin, China.
Tiemin
T
Jiang
Department of Cardiology, Jinan Military General Hospital, Jinan, China.
Xiaoyan
X
Li
Department of Cardiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Wei
W
Wang
Department of Cardiology, Wuhan General Hospital of Guangzhou Military, Wuhan, China.
Shifang
S
Ding
Department of Cardiology, Affiliated Hospital of Ningxia Medical College, Yinchuan, China.
Shaobin
S
Jia
Department of Cardiology, Ruijin Hospital Affiliated to the Medical College of Shanghai Jiaotong University, Shanghai, China.
Weifeng
W
Shen
Department of Cardiology, Shijiazhuang International Peace Hospital, Shijiazhuang, China.
Dongmei
D
Wang
Department of Cardiology, Fushun Central Hospital, Fushun, China.
Ling
L
Sun
Department of Cardiology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, China.
Jian
J
Qiu
Department of Cardiology, Shenyang Northern Hospital, Shenyang, China.
Xiaozeng
X
Wang
Department of Cardiology, Shenyang Northern Hospital, Shenyang, China.
Yi
Y
Li
Department of Cardiology, Shenyang Northern Hospital, Shenyang, China.
Jie
J
Deng
Department of Cardiology, Shenyang Northern Hospital, Shenyang, China.
Jing
J
Li
Department of Cardiology, Shenyang Northern Hospital, Shenyang, China.
Kai
K
Xu
Cardiac Catheterization Laboratory, Fuwai Hospital, Beijing, China.
Bo
B
Xu
Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
Roxana
R
Mehran
Department of Cardiology, First Hospital of Beijing University, Beijing, China.
Yong
Y
Huo
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000517:prevention & control*; D000792:Angiography / Q000009:adverse effects* / Q000379:methods; D003287:Contrast Media / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging; D004305:Dose-Response Relationship, Drug; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use*; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000000981:diagnostic imaging; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
D003287:Contrast Media; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium
CI-AKI; CKD; DM; LDL-C; ST-segment elevation myocardial infarction; STEMI; TC; angiography; chronic kidney disease; contrast medium; contrast-induced acute kidney injury; diabetes mellitus; eGFR; estimated glomerular filtration rate; high-sensitivity C-reactive protein; hsCRP; kidney; low-density lipoprotein cholesterol; sCr; serum creatinine; statins; total cholesterol