title: Preventive effect of statin pretreatment on contrast-induced acute kidney injury in patients undergoing coronary angioplasty: propensity score analysis from a multicenter registry.
abstract: BACKGROUND
  The prophylactic benefit of statins in reducing the incidence of contrast-induced acute kidney injury (CI-AKI) has been investigated in several studies with conflicting results. We sought to investigate whether statin pretreatment prevents CI-AKI in coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI).
  
  
  METHODS
  A total of 2198 CAD patients who underwent PCI, except for those undergoing dialysis or who died within 7 days after angioplasty, were analyzed from the ICAS (Ibaraki Cardiovascular Assessment Study) multicenter registry. Analyzed subjects were divided into 2 groups according to statin pretreatment: statin pretreatment (n=839) and non-statin pretreatment (n=1359). Selection bias of statin pretreatment was adjusted by propensity score-matching method: pretreatment statin (n=565) and non-statin pretreatment (n=565). CI-AKI was defined as an increase in serum creatinine of ≥ 25% or 0.5mg/dl from baseline within 1 week of contrast medium exposure.
  
  
  RESULTS
  A total of 192 (8.7%) patients developed CI-AKI. No significant differences were observed in baseline patient characteristics between the statin and non-statin pretreatment groups after propensity score matching. In the propensity score-matched groups, the incidence of CI-AKI was significantly lower in patients with statin pretreatment than in those without statin pretreatment (3.5% vs.10.6%, odds ratio [OR]: 0.31, 95% confidence interval [CI]: 0.18-0.52, P<0.001). Multivariate logistic regression analysis showed that statin pretreatment remained an independent negative predictor of CI-AKI (OR: 0.31, 95% CI: 0.18-0.53, P<0.001) among propensity score-matched subjects.
  
  
  CONCLUSIONS
  Statin pretreatment was associated with a significant decrease in the risk of CI-AKI in CAD patients undergoing PCI in the ICAS Registry.
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. Electronic address: hoshi.tm@md.tsukuba.ac.jp.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hoshi
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sato
authors.affiliation: Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kakefuda
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Harunari
authors.affiliation: Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Watabe
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Ojima
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Daigo
authors.initials: D
authors.lastname: Hiraya
authors.affiliation: Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Abe
authors.affiliation: Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Japan.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Nishina
authors.affiliation: Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Takeyasu
authors.affiliation: Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Noguchi
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Aonuma
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment
chemical_list: D003287:Contrast Media; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Contrast-induced acute kidney injury; Mehran risk score; Propensity score; Statin