title: Impact of an Early Decrease in Systolic Blood Pressure on The Risk of Contrast-Induced Nephropathy after Percutaneous Coronary Intervention.
abstract: BACKGROUND
  The early postprocedural period was thought to be the rush hour of contrast media excretion, causing rapid and prolonged renal hypoperfusion, which was the critical time window for contrast-induced nephropathy (CIN).
  
  
  METHODS
  349 consecutive patients were enrolled into the study. The relation between an early postprocedural decrease in systolic blood pressure (SBP) and the risk of CIN was assessed using multivariate logistic regression.
  
  
  RESULTS
  A postprocedural decrease in SBP was observed in 63% of patients and CIN developed in 28 (8.0%) patients. The CIN group had a lower postprocedural SBP (114.5±13.5 vs. 123.7±15.6mmHg, P=0.003) and a greater postprocedural decrease in SBP (16.2±19.1 vs. 5.9±18.7mmHg, P=0.005) than the no-CIN group. ROC analysis revealed that the optimum cutoff value for the SBP decrease in detecting CIN was >10mmHg (sensitivity 60.7%, specificity 59.5%, AUC=0.66). Multivariate logistic regression analysis found that a postprocedural decrease in SBP >10mmHg was a significant independent predictor of CIN (OR 2.368, 95%CI: 1.043-5.379, P=0.039), after adjustment for other risk factors.
  
  
  CONCLUSIONS
  An early moderate postprocedural decrease in SBP may increase the risk of CIN in patients undergoing PCI.
authors: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
authors: Hualong
authors: H
authors: Li
authors: Guangzhou First People's Hospital, Guangzhou, Guangdong, China.
authors: Shuijin
authors: S
authors: Huang
authors: The First People's Hospital of Shunde, Shunde, Guangdong, China.
authors: Yiting
authors: Y
authors: He
authors: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China. Electronic address: liuyong2099@126.com.
authors: Yong
authors: Y
authors: Liu
authors: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
authors: Yuanhui
authors: Y
authors: Liu
authors: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
authors: Jiyan
authors: J
authors: Chen
authors: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China. Electronic address: zylgdh@126.com.
authors: Yingling
authors: Y
authors: Zhou
authors: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China. Electronic address: tanningdr@126.com.
authors: Ning
authors: N
authors: Tan
authors: National Clinical Research Center for Kidney Disease, Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
authors: Chongyang
authors: C
authors: Duan
authors: National Clinical Research Center for Kidney Disease, Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
authors: Pingyan
authors: P
authors: Chen
mesh_terms: D000368:Aged; D001794:Blood Pressure; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D012307:Risk Factors
chemical_list: D003287:Contrast Media
keywords: Contrast-induced nephropathy; Haemodynamic instability; Percutaneous coronary intervention; Systolic blood pressure