title: Remedial hydration reduces the incidence of contrast-induced nephropathy and short-term adverse events in patients with ST-segment elevation myocardial infarction: a single-center, randomized trial.
abstract: OBJECTIVE
  The aim of this study was to investigate whether remedial hydration (RH) reduces the incidence of contrast-induced nephropathy (CIN) and short-term adverse events in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  A total of 216 consecutive STEMI patients were prospectively and randomly assigned into two groups: 108 patients in the RH group and 108 patients in the no RH (control) group. The serum creatinine (SCr) and creatinine clearance (CCr) levels were measured on admission and at 24, 48 and 72 hours after primary PCI. The rates of CIN and short-term adverse events were analyzed for each group. After surgery, the patients were categorized into four groups according to the Mehran risk score: low (≤5, n =98), moderate (6-10, n=56), high (11-15, n=40) or very high (≥16, n=22).
  
  
  RESULTS
  The incidence of CIN in the RH group was lower than that observed in the control group (22/108; 20.4% vs. 38/108; 35.2%, p<0.05). The subgroup analysis showed that the rate of CIN was lower in the moderate (6/29; 20.7% vs. 13/30; 43.3%, p<0.10) and significantly lower in both the high (5/21; 23.8% vs. 10/18; 55.6%, p<0.05) and very high score groups (3/12; 25.0% vs. 8/12; 66.7%, p<0.05) among the RH patients compared to the controls. At 24, 48 and 72 hours after PCI, the patients in the RH group exhibited lower SCr levels and higher CCr levels than the patients in the control group (both p<0.05). A lower incidence of in-hospital clinical events was also observed in the RH group.
  
  
  CONCLUSIONS
  Remedial hydration decreases the occurrence of CIN and improves the short-term prognosis of STEMI patients undergoing primary PCI.
authors.affiliation: Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Luo
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Wang
authors.forename: Zi
authors.initials: Z
authors.lastname: Ye
authors.forename: Yan
authors.initials: Y
authors.lastname: Lai
authors.forename: Yian
authors.initials: Y
authors.lastname: Yao
authors.forename: Jimin
authors.initials: J
authors.lastname: Li
authors.forename: Xuebo
authors.initials: X
authors.lastname: Liu
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D004562:Electrocardiography; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000517:prevention & control*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D003287:Contrast Media; D003404:Creatinine