TY - JOUR
T1 - Statin therapy reduces contrast-induced nephropathy
T2 - An analysis of contemporary percutaneous interventions
AU - Khanal, Sanjaya
AU - Attallah, Nizar
AU - Smith, Dean E.
AU - Kline-Rogers, Eva
AU - Share, David
AU - O'Donnell, Michael J.
AU - Moscucci, Mauro
N1 - Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2005/8
Y1 - 2005/8
N2 - PURPOSE: We sought to examine whether statin therapy before percutaneous coronary intervention results in reduction in contrast-induced nephropathy (CIN). Intravascular administration of contrast media can have nephrotoxic effects, particularly in patients with baseline renal insufficiency. Along with lowering serum cholesterol, statins have pleiotropic effects in the vasculature. The effect of statin use on CIN is unknown. SUBJECTS AND METHODS: We studied 29 409 patients who had both baseline preprocedure and peak postprocedure serum creatinine measured at the time of their percutaneous coronary intervention (PCI). Baseline demographics and creatinine profile before and after the procedure were compared between patients who received preprocedure statins and those who did not. CIN was defined as an increase in serum creatinine of ≤0.5 mg/dL. RESULTS: Baseline serum creatinine was similar between the two groups. When compared with patients who did not receive preprocedure statins, patients on preprocedure statins had a lower incidence of CIN (4.37 vs 5.93, P <0.0001) and nephropathy requiring dialysis (0.32 vs 0.49, P = 0.03). After adjustments for comorbidities, preprocedure statin use was associated with a significant reduction in CIN (odds ration [OR] 0.87, 95% confidence interval [CI] 0.77-0.99, P = 0.03). CONCLUSIONS: Preprocedure statin use is associated with significant reduction in CIN after contemporary PCI. This reinforces the need to initiate statin therapy before percutaneous coronary interventions.
AB - PURPOSE: We sought to examine whether statin therapy before percutaneous coronary intervention results in reduction in contrast-induced nephropathy (CIN). Intravascular administration of contrast media can have nephrotoxic effects, particularly in patients with baseline renal insufficiency. Along with lowering serum cholesterol, statins have pleiotropic effects in the vasculature. The effect of statin use on CIN is unknown. SUBJECTS AND METHODS: We studied 29 409 patients who had both baseline preprocedure and peak postprocedure serum creatinine measured at the time of their percutaneous coronary intervention (PCI). Baseline demographics and creatinine profile before and after the procedure were compared between patients who received preprocedure statins and those who did not. CIN was defined as an increase in serum creatinine of ≤0.5 mg/dL. RESULTS: Baseline serum creatinine was similar between the two groups. When compared with patients who did not receive preprocedure statins, patients on preprocedure statins had a lower incidence of CIN (4.37 vs 5.93, P <0.0001) and nephropathy requiring dialysis (0.32 vs 0.49, P = 0.03). After adjustments for comorbidities, preprocedure statin use was associated with a significant reduction in CIN (odds ration [OR] 0.87, 95% confidence interval [CI] 0.77-0.99, P = 0.03). CONCLUSIONS: Preprocedure statin use is associated with significant reduction in CIN after contemporary PCI. This reinforces the need to initiate statin therapy before percutaneous coronary interventions.
KW - Angioplasty
KW - Contrast media
KW - Contrast nephropathy
KW - Kidney
KW - Lipids
UR - http://www.scopus.com/inward/record.url?scp=23244448755&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=23244448755&partnerID=8YFLogxK
U2 - 10.1016/j.amjmed.2005.03.031
DO - 10.1016/j.amjmed.2005.03.031
M3 - Article
C2 - 16084176
AN - SCOPUS:23244448755
VL - 118
SP - 843
EP - 849
JO - American Journal of Medicine
JF - American Journal of Medicine
SN - 0002-9343
IS - 8
ER -