title: Safe contrast volumes for preventing contrast-induced nephropathy in elderly patients with relatively normal renal function during percutaneous coronary intervention.
abstract: The aim of this study was to evaluate contrast media volume to creatinine clearance (V/CrCl) ratio for predicting contrast-induced nephropathy (CIN) and to determine a safe V/CrCl cut off value to avoid CIN in elderly patients with relatively normal renal function during percutaneous coronary intervention (PCI). We prospectively enrolled 1020 consecutive elderly patients (age ≥65 years) with relative normal renal function (baseline serum creatinine <1.5 mg/dL) undergoing PCI. Receiver operating characteristic (ROC) curves were used to identify the optimal cut off value of V/CrCl for detecting CIN. The predictive value of V/CrCl for CIN was assessed with a multivariate logistic regression. Thirty-nine patients (3.8%) developed CIN. There was a significant association between a higher V/CrCl ratio and CIN risk (P < 0.001). ROC curve analysis indicated that a V/CrCl ratio of 2.74 was a fair discriminator for CIN (C statistic = 0.68). After adjusting for other known CIN risk factors, V/CrCl ratios >2.74 remained significantly associated with CIN (odds ratio = 3.21, 95% confidence interval [CI] 1.45-7.09, P = 0.004) and worse long-term mortality (hazard ratio = 1.96, 95% CI 1.14-3.38, P = 0.016). A V/CrCl ratio >2.74 was a significant independent predictor of CIN and was independently associated with long-term mortality in elderly patients with relatively normal renal function.
authors: From the Department of Cardiology (YL, J-yC, NT, Y-lZ, D-qY, N-jX, H-lL), Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences; Department of cardiology, Guangdong General Hospital, Southern Medical University (Y-hL); and Department of Biostatistics (C-yD, P-yC), School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
authors: Yong
authors: Y
authors: Liu
authors: Yuan-Hui
authors: YH
authors: Liu
authors: Ji-Yan
authors: JY
authors: Chen
authors: Ning
authors: N
authors: Tan
authors: Ying-Ling
authors: YL
authors: Zhou
authors: Chong-Yang
authors: CY
authors: Duan
authors: Dan-Qing
authors: DQ
authors: Yu
authors: Nian-Jin
authors: NJ
authors: Xie
authors: Hua-Long
authors: HL
authors: Li
authors: Ping-Yan
authors: PY
authors: Chen
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage*; D003404:Creatinine / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced* / Q000517:prevention & control*; D008297:Male; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications; D011446:Prospective Studies; D012372:ROC Curve; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data
chemical_list: D003287:Contrast Media; D003404:Creatinine