title: Angiotensin-Converting Enzyme Inhibitor Prevents the Worsening of Renal Function in the Late Phase after Percutaneous Coronary Intervention.
abstract: OBJECTIVE
  The amount of contrast media and renal atheroemboli are risk factors for acute kidney injury after percutaneous coronary intervention (PCI). However, the chronic kidney injury after PCI has not been fully characterized. The purpose of this study was to investigate factors affecting renal function in the late phase after PCI by measuring serum Cystatin C (CysC).
  
  
  METHODS
  In 143 consecutive patients who underwent elective PCI, CysC was evaluated at baseline and at 9 months after PCI, and the percent change in CysC (%CysC) was calculated. The association between %CysC and baseline characteristics, including medication use, was assessed.
  
  
  RESULTS
  Of 143 patients, 86 had worsening renal function (WRF; %CysC ≥0), and 57 did not (non-WRF; %CysC <0). Only the use of angiotensin-converting enzyme inhibitor (ACEI) and baseline CysC were significantly different between WRF and non-WRF patients (15 vs. 40%, p=0.001 and 1.02±0.26 vs. 1.13±0.26 mg/L, p=0.015). In univariate analysis, the use of ACEI and CysC were negatively associated with WRF [Odds ratio (OR)=0.26, 95% confidence interval (CI)=0.12-0.57, p<0.001 and OR=0.20, 95% CI=0.05-0.73, p=0.015]. Furthermore, multivariate analysis revealed that the use of ACEI and CysC significantly correlated with WRF (OR=0.26, 95% CI=0.11-0.57, p<0.001 and OR=0.20, 95% CI=0.05-0.74, p=0.016). The %CysC in 36 patients with ACEI was significantly lower than that in 107 patients without ACEI [median: -3.8%; interquartile range (IQR), -11.0 to 4.2%; vs. median: 3.3%; IQR -2.9 to 11.0%, p=0.001].
  
  
  CONCLUSIONS
  The use of ACEI was associated with lower CysC after PCI, suggesting that ACEI prevents worsening of renal function in late phase after PCI.
authors.affiliation: Department of Cardiovascular Medicine and Hypertension, Graduate School of Medicine and Dental Sciences, Kagoshima University.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kanda
authors.forename: Takuro
authors.initials: T
authors.lastname: Takumi
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyata
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tokushige
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sonoda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yoshino
authors.forename: Keishi
authors.initials: K
authors.lastname: Saihara
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ohishi
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood*; D003324:Coronary Artery Disease / Q000150:complications* / Q000628:therapy; D055316:Cystatin C / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011379:Prognosis; D012307:Risk Factors
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D015415:Biomarkers; D055316:Cystatin C