title: Relation of contrast-induced nephropathy to long-term mortality after percutaneous coronary intervention.
abstract: There is little information on the effect of contrast-induced nephropathy (CIN) on long-term mortality after percutaneous coronary intervention in patients with or without chronic kidney disease (CKD). Of 4,371 patients who had paired serum creatinine (SCr) measurements before and after percutaneous coronary intervention and were discharged alive in the Coronary REvascularization Demonstrating Outcome Study in Kyoto registry, the incidence of CIN (an increase in SCr of ≥0.5 mg/dl from the baseline) was 5% in our study cohort. The rate of CIN in patients with CKD was 11%, although it was 2% without CKD (p <0.0001). During a median follow-up of 42.3 months after discharge, 374 patients (8.6%) died. After adjustment for prespecified confounders, CIN was significantly correlated with long-term mortality in the entire cohort (hazard ratio [HR] 2.26, 95% confidence interval [CI] 1.62 to 2.29, p <0.0001) and in patients with CKD (HR 2.62, 95% CI 1.91 to 3.57, p <0.0001) but not in patients without CKD (HR 1.23, 95% CI 0.47 to 2.62, p = 0.6). Sensitivity analyses confirmed these results using the criteria defined as elevations of the SCr by ≥25% and 0.3 mg/dl from the baseline, respectively. In conclusion, CIN was significantly correlated with long-term mortality in patients with CKD but not in those without CKD.
authors.affiliation: Division of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. Electronic address: mitabe@kyotolan.hosp.go.jp.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Abe
authors.affiliation: Division of General Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.affiliation: Division of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Akao
authors.affiliation: Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Furukawa
authors.affiliation: Division of Cardiology, Tenri Hospital, Tenri, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nakagawa
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shizuta
authors.affiliation: Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Natsuhiko
authors.initials: N
authors.lastname: Ehara
authors.affiliation: Division of Cardiology, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Taniguchi
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Doi
authors.affiliation: Department of Primary Care and Emergency Medicine, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Nishiyama
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Neiko
authors.initials: N
authors.lastname: Ozasa
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Naritatsu
authors.initials: N
authors.lastname: Saito
authors.affiliation: Division of Cardiology, Nagai Hospital, Tsu, Japan.
authors.forename: Kozo
authors.initials: K
authors.lastname: Hoshino
authors.affiliation: Division of Cardiology, Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Mitsuoka
authors.affiliation: Division of Cardiology, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Japan.
authors.forename: Masanao
authors.initials: M
authors.lastname: Toma
authors.affiliation: Division of Cardiology, Tenri Hospital, Tenri, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Tamura
authors.affiliation: Division of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan.
authors.forename: Yoshisumi
authors.initials: Y
authors.lastname: Haruna
authors.affiliation: Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kita
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D003404:Creatinine / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000175:diagnosis / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
chemical_list: D003287:Contrast Media; D003404:Creatinine