title: Incidence of persistent renal dysfunction after contrast enhanced coronary CT angiography in patients with suspected coronary artery disease.
abstract: Contrast-induced nephropathy (CIN) is a potentially serious complication of contrast agents used in computed tomography angiography (CTA). The aim of this study was to evaluate whether persistent renal dysfunction occurs in patients undergoing coronary CTA for suspected stable coronary artery disease (CAD). From a cohort of 957 patients undergone coronary CTA, we identified 402 patients with plasma creatinine levels collected before and within 6 months after CTA. According to the definition of CIN, patients with a ≥25 % increase in plasma creatinine after CTA were evaluated. The post-CTA measurements in 402 patients (195 men, age 62.9 ± 9.3 years) were performed at a median of 99 days after CTA. On average, there was no change in plasma creatinine level between the pre- and post-CTA measurements (75.8 ± 16.0 and 75.7 ± 16.4 µmol/L, respectively; P = 0.63) but both increases and decreases were commonly detected. Fourteen (3.5 %) patients had a ≥25 % increase in plasma creatinine levels after CTA. A more detailed evaluation of these patients revealed that in 4 patients the increase was explained by other morbidities, whereas in 9 patients the creatinine level returned to the previous levels at later follow-up (median time to normalization: 311 days). Only in 1 (0.2 %) remaining patient, there was a persistent increase in plasma creatinine level, possibly related to the iodine contrast agent exposure. Alterations in plasma creatinine concentration occur frequently. Persistent renal dysfunction attributable to iodine contrast agent exposure is rare in patients referred to coronary CTA for suspected CAD.
authors.affiliation: Turku PET Centre, Turku University Hospital, University of Turku, P.O. Box 52, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
authors.forename: Teemu
authors.initials: T
authors.lastname: Maaniitty
authors.affiliation: Turku PET Centre, Turku University Hospital, University of Turku, P.O. Box 52, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
authors.forename: Iida
authors.initials: I
authors.lastname: Stenström
authors.affiliation: Turku PET Centre, Turku University Hospital, University of Turku, P.O. Box 52, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
authors.forename: Valtteri
authors.initials: V
authors.lastname: Uusitalo
authors.affiliation: Heart Center, Turku University Hospital, Turku, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Ukkonen
authors.affiliation: Turku PET Centre, Turku University Hospital, University of Turku, P.O. Box 52, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
authors.forename: Sami
authors.initials: S
authors.lastname: Kajander
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.affiliation: Turku PET Centre, Turku University Hospital, University of Turku, P.O. Box 52, Kiinamyllynkatu 4-8, 20521, Turku, Finland.|Heart Center, Turku University Hospital, Turku, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Saraste
authors.affiliation: Turku PET Centre, Turku University Hospital, University of Turku, P.O. Box 52, Kiinamyllynkatu 4-8, 20521, Turku, Finland. juhani.knuuti@utu.fi.|Department of Clinical Physiology, Nuclear Medicine and PET, Turku University Hospital, Turku, Finland. juhani.knuuti@utu.fi.
authors.forename: Juhani
authors.initials: J
authors.lastname: Knuuti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D000072226:Computed Tomography Angiography / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003404:Creatinine / Q000097:blood; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D007674:Kidney Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D003404:Creatinine
keywords: Computed tomography angiography; Coronary artery disease; Iodinated contrast media; Kidney function; Nephropathy