Abe M, et al. - Contrast-induced nephropathy (CIN) is associated with increased long-term mortality. However, it is still controversial if CIN is the cause of increased mortality or merely a marker of high-risk patients. In this current study, it was demonstrated that only persistent CIN was independently associated with increased long-term mortality in patients who underwent their first elective percutaneous coronary intervention (PCI) and developed post-procedure CIN.

Methods

• Researchers included in this study a total of 5516 patients who underwent their first elective percutaneous coronary intervention (PCI) in the CREDO-Kyoto registry cohort-2.
• CIN was defined as an elevation in the peak serum creatinine (SCr) of ≥0.5 mg/dL from the baseline within 5 days after PCI.

Results

• Findings demonstrated that CIN, seen in 218 patients (4.0%), was independently associated with an increased long-term mortality risk (HR, 1.43; 95%CI, 1.11 to 1.83; p = 0.005).
• Data also reported that SCr data at 1 year (180 to 550 days) after PCI were available in 3986 patients, who were subdivided into persistent CIN (follow-up SCr elevation ≥0.5 mg/dL: N = 50 [1.3%]), transient CIN (follow-up SCr elevation <0.5 mg/dL: N = 90 [2.3%]), and non-CIN (N = 3846 [96.5%]).
• In the landmark analysis at 1 year after PCI, it was evident that 524 patients (13.1%) died during a median follow-up of 1521 days.
• Researchers also observed that after adjustment for the 37 confounders, persistent CIN, but not transient CIN, was significantly correlated with a higher long-term mortality risk compared with non-CIN (HR, 1.84; 95%CI, 1.12 to 3.03; p = 0.02, and HR, 1.11; 95%CI, 0.71 to 1.76; p = 0.6, respectively).