title: Relation of contrast nephropathy to adverse events in pulmonary emboli patients diagnosed with contrast CT.
abstract: OBJECTIVE
  Limited data exist on the incidence of contrast induced nephropathy (CIN) and its impact on in-hospital prognosis of patients diagnosed with acute pulmonary embolism (APE) using contrast computerized tomography pulmonary angiography (CTPA). In this study, we examined the frequency of nephropathy after CTPA in APE patients and its link to in-hospital adverse outcomes.
  
  
  METHODS
  This was a retrospective study of 189 patients (mean age 67+16years, 48% male) with APE who underwent CTPA. CIN was defined as a≥0.5mg/dl and/or ≥25% increase in serum creatinine levels >48hours after CTPA. Patients were divided into two groups according to the presence or absence of CIN to compare clinical characteristics, risk factors, and in-hospital adverse events.
  
  
  RESULTS
  Twenty-four (13%) of the patients were diagnosed with CIN. Patients with CIN were older (73±17 vs. 67±15years, P=.01) and had higher rates of heart failure (17% vs. 6%, P=.04). Preexisting renal dysfunction and advanced age were found to be independent predictors of CIN (OR: 4.2, 95% CI: 1.5-11.9, P=.006; OR: 3.2, 95% CI: 1.1-9.8, P=.03 respectively). The in-hospital adverse event rate was significantly higher in patients with CIN (16.7% vs. 2.4%, P=.001). A multivariate analysis revealed CIN as an independent predictor of in-hospital adverse event rate (OR: 6.1, 95%CI: 1.2-29.3, P=.02).
  
  
  CONCLUSIONS
  CIN is associated with a higher in-hospital adverse event rate in APE patients diagnosed using CTPA. This is first large study to focus specifically on CIN in patients diagnosed with APE using CTPA.
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey. Electronic address: dr.selcuk75@gmail.com.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Yazıcı
authors.affiliation: Katip Celebi University, Atatürk Training and ResearchHospital, Cardiology Clinic, Izmir, Turkey. Electronic address: drtkiris@hotmail.com.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Kırış
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey. Electronic address: dremreayse@gmail.com.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Emre
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey. Electronic address: ufukceylan@gmail.com.
authors.forename: Ufuk S
authors.initials: US
authors.lastname: Ceylan
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey. Electronic address: sukruakyuz@hotmail.com.
authors.forename: Şükrü
authors.initials: Ş
authors.lastname: Akyüz
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey. Electronic address: ahmetokanuzun@mynet.com.
authors.forename: Ahmet O
authors.initials: AO
authors.lastname: Uzun
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey. Electronic address: dr.recephaci@gmail.com.
authors.forename: Recep
authors.initials: R
authors.lastname: Hacı
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey. Electronic address: saitterzi53@gmail.com.
authors.forename: Sait
authors.initials: S
authors.lastname: Terzi
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey. Electronic address: erdemaysun@yahoo.com.
authors.forename: Aysun
authors.initials: A
authors.lastname: Erdem
authors.affiliation: Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Clinic, İstanbul, Turkey. Electronic address: kemalyess@gmail.com.
authors.forename: Kemal
authors.initials: K
authors.lastname: Yeşilçimen
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects*
chemical_list: D003287:Contrast Media