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  • 1
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    Online Resource
    Association of Early and Late Contrast-Associated Acute Kidney Injury and Long-Term Mortality in Patients Undergoing Coronary Angiography
    Hindawi Limited ; 2021
    In:  Journal of Interventional Cardiology Vol. 2021 ( 2021-3-5), p. 1-8
    Details
    In: Journal of Interventional Cardiology, Hindawi Limited, Vol. 2021 ( 2021-3-5), p. 1-8
    Abstract: Background. Contrast-associated acute kidney injury (CA-AKI) is a common complication in patients undergoing coronary angiography (CAG). However, few studies demonstrate the association between the prognosis and developed CA-AKI in the different periods after the operation. Methods. We retrospectively enrolled 3206 patients with preoperative serum creatinine (Scr) and at least twice SCr measurement after CAG. CA-AKI was defined as an increase ≥50% or ≥0.3 mg/dL from baseline in the 72 hours after the procedure. Early CA-AKI was defined as having the first increase in SCr within the early phase ( 〈 24 hours), and late CA-AKI was defined as an increase in SCr that occurred for the first time in the late phase (24–72 hours). The first endpoint of this study was long-term all-cause mortality. Kaplan–Meier analysis was used to count the cumulative mortality, and the log-rank test was used to assess differences between curves. Univariate and multivariate cox regression analyses were performed to assess whether patients who developed different type CA-AKI were at increased risk of long-term mortality. Results. The number of deaths in the 3 groups was 407 for normal (12.7%), 106 for early CA-AKI (32.7%) and 57 for late CA-AKI (17.7%), during a median follow-up period of 3.95 years. After adjusting for important clinical variables, early CA-AKI (HR = 1.33, 95% CI: 1.02–1.74, P = 0.038 ) was significantly associated with mortality, while late CA-AKI (HR = 0.92, 95% CI: 0.65–1.31, P = 0.633 ) was not. The same results were found in patients with coronary artery disease, chronic kidney disease, diabetes mellitus, and percutaneous coronary intervention. Conclusions. Early increases in Scr, i.e., early CA-AKI, have better predictive value for long-term mortality. Therefore, in clinical practice, physicians should pay more attention to patients with early renal injury related to long-term prognosis and give active treatment.
    Type of Medium: Online Resource
    ISSN: 1540-8183 , 0896-4327
    URL: Article
    DOI: 10.1155/2021/6641887
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2021
    detail.hit.zdb_id: 2103585-4
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  • 2
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    Trends in incidence and long-term prognosis of acute kidney injury following coronary angiography in Chinese cohort with 11,943 patients from 2013 to 2017: an observational study
    Springer Science and Business Media LLC ; 2021
    In:  BMC Nephrology Vol. 22, No. 1 ( 2021-12)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2021-12)
    Abstract: Contrast-associated acute kidney injury (CA-AKI) is a common complication with poor prognosis after coronary angiography (CAG). With the prevention methods widely being implemented, the temporal trends of incidence and mortality of CA-AKI are still unknown over the last five years. The study aims to determine the incidence and prognosis of CA-AKI in China. Methods This retrospective cohort study was based on the registry at Guangdong Provincial People’s Hospital in China (ClinicalTrials.gov NCT04407936). We analyzed data from hospitalization patients who underwent CAG and with preoperative and postoperative serum creatinine (Scr) values from January 2013 to December 2017. Results 11,943 patients were included in the study, in which the mean age was 63.01 ± 10.79 years and 8,469 (71.1 %) were male. The overall incidence of CA-AKI was 11.2 %. Compared with 2013, the incidence of CA-AKI in 2017 was significantly increased from 9.7 to 13.0 % (adjusted odds ratios [aOR], 1.38; 95 %CI, 1.13–1.68; P -value  〈  0.01, P for trend  〈  0.01). The temporal trends of incidence among patients of different ages and genders yielded similar findings. During a standardized follow-up of 1 year, 178 (13.7 %) CA-AKI patients died in total, which showed no obvious decreased trend in this 5 five years from 21.1 to 16.5 (adjusted hazard ratio [aHR], 0.72; 95 %CI, 0.36–1.45; P -value = 0.35, P for trend = 0.24). Conclusions Our Chinese cohort showed that the incidence of CA-AKI increased significantly, while CA-AKI associated mortality showed no obvious decreased trend in the last five years. Our findings support more active measures to prevent CA-AKI and improve the prognosis of CA-AKI patients.
    Type of Medium: Online Resource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/s12882-021-02427-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041348-8
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  • 3
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    Correction to: The global incidence and mortality of contrast-associated acute kidney injury following coronary angiography: a meta-analysis of 1.2 million patients
    Springer Science and Business Media LLC ; 2021
    In:  Journal of Nephrology Vol. 34, No. 5 ( 2021-10), p. 1785-1785
    Details
    In: Journal of Nephrology, Springer Science and Business Media LLC, Vol. 34, No. 5 ( 2021-10), p. 1785-1785
    Type of Medium: Online Resource
    ISSN: 1121-8428 , 1724-6059
    URL: Article
    DOI: 10.1007/s40620-021-01090-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1475007-7
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  • 4
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    A prediction model of contrast-associated acute kidney injury in patients with hypoalbuminemia undergoing coronary angiography
    Springer Science and Business Media LLC ; 2020
    In:  BMC Cardiovascular Disorders Vol. 20, No. 1 ( 2020-12)
    Details
    In: BMC Cardiovascular Disorders, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: Risk stratification is recommended as the key step to prevent contrast-associated acute kidney injury (CA-AKI) among at-risk patients following coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). Patients with hypoalbuminemia are prone to CA-AKI and do not have their own risk stratification tool. Therefore, this study developed and validated a new model for predicting CA-AKI among hypoalbuminemia patients CAG/PCI. Methods 1272 patients with hypoalbuminemia receiving CAG/PCI were enrolled and randomly allocated (2:1 ratio) into the development cohort ( n  = 848) and the validation cohort ( n  = 424). CA-AKI was defined as an increase of ≥0.3 mg/dL or 50% in serum creatinine (SCr) compared to baseline in the 48 to 72 h after CAG/PCI. A prediction model was established with independent predictors according to stepwise logistic regression, showing as a nomogram. The discrimination of the new model was evaluated by the area under the curve (AUC) and was compared to the classic Mehran CA-AKI model. The Hosmer-Lemeshow test was conducted to assess the calibration of our model. Results Overall, 8.4% (71/848) patients of the development group and 11.2% (48/424) patients of the validation group experienced CA-AKI. A new nomogram included estimated glomerular filtration rate (eGFR), serum albumin (ALB), age and the use of intra-aortic balloon pump (IABP); showed better predictive ability than the Mehran score (C-index 0.756 vs. 0.693, p  = 0.02); and had good calibration (Hosmer–Lemeshow test p  = 0.187). Conclusions We developed a simple model for predicting CA-AKI among patients with hypoalbuminemia undergoing CAG/PCI, but our findings need validating externally. Trial registration http://www.ClinicalTrials.gov NCT01400295 , retrospectively registered 21 July 2011.
    Type of Medium: Online Resource
    ISSN: 1471-2261
    URL: Article
    DOI: 10.1186/s12872-020-01689-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2059859-2
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  • 5
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    A comparison between two different definitions of contrast-associated acute kidney injury for long-term mortality in patients with diabetes undergoing coronary angiography: a prospective cohort study
    Springer Science and Business Media LLC ; 2020
    In:  BMC Cardiovascular Disorders Vol. 20, No. 1 ( 2020-12)
    Details
    In: BMC Cardiovascular Disorders, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: The definitions of contrast-associated acute kidney injury (CA-AKI) are diverse and have different predictive effects for prognosis, which are adverse for clinical practice. Few articles have discussed the relationship between these definitions and long-term prognosis in patients with diabetes. Methods A total of 1154 diabetic patients who were undergoing coronary angiography (CAG) were included in this study. Two definitions of CA-AKI were used: CA-AKI A was defined as an increase ≥ 0.3 mg/dl or  〉  50% in serum creatinine (SCr) from baseline within 72 h after CAG, and CA-AKI B was defined as an increase ≥ 0.5 mg/dl or  〉  25% in SCr from baseline within 72 h after CAG. We used Cox regression to evaluate the association of these two CA-AKI definitions with long-term mortality and calculate the population attributable risks (PARs) of different definitions for long-term prognosis. Results During the median follow-up period of 7.4 (6.2–8.2) years, the overall long-term mortality was 18.84%, and the long-term mortality in patients with CA-AKI according to both CA-AKI A and CA-AKI B criteria were 36.73% and 28.86%, respectively. We found that CA-AKI A (HR: 2.349, 95% CI 1.570–3.517, p  = 0.001) and CA-AKI B (HR: 1.608, 95% CI 1.106–2.339, p  = 0.013) were associated with long-term mortality. The PARs were the highest for CA-AKI A (31.14%), followed by CA-AKI B (14.93%). Conclusions CA-AKI is a common complication in diabetic patients receiving CAG. The two CA-AKI definitions are significantly associated with a poor long-term prognosis, and CA-AKI A , with the highest PAR, needs more clinical attention.
    Type of Medium: Online Resource
    ISSN: 1471-2261
    URL: Article
    DOI: 10.1186/s12872-020-01778-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2059859-2
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  • 6
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    Association Between Non-Recovered Contrast-Associated Acute Kidney Injury and Poor Prognosis in Patients Undergoing Coronary Angiography
    Frontiers Media SA ; 2022
    In:  Frontiers in Cardiovascular Medicine Vol. 9 ( 2022-3-7)
    Details
    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 9 ( 2022-3-7)
    Abstract: Previous studies have shown that renal function recovery after acute kidney injury (AKI) was associated with decreased risk of all-cause mortality. However, little is known about the correlation between renal function recovery and long-term prognosis in patients with contrast-associated acute kidney injury (CA-AKI) undergoing coronary angiography (CAG). Methods We retrospectively enrolled 5,865 patients who underwent CAG. CA-AKI was defined as an increase in serum creatinine (SCr) ≥ 50% or ≥ 0.3 mg/dl from baseline within 72 h post procedure. Recovered CA-AKI was defined as a decrease in SCr to baseline or no CA-AKI level. The first endpoint was long-term all-cause mortality. Kaplan–Meier analysis and Cox regression analysis were used to investigate the association between kidney function recovery and long-term mortality. Results During the median follow-up period of 5.25 years, the overall long-term mortality was 20.07%, and the long-term mortality in patients with recovered CA-AKI and non-recovered CA-AKI was 17.46 and 27.44%, respectively. After multivariate Cox hazard regression, non-recovered CA-AKI was significantly associated with long-term mortality, while recovered CA-AKI was not [recovered CA-AKI vs. no CA-AKI, hazard ratio (HR) = 1.06, 95% confidence interval (CI): 0.81–1.39, p = 0.661; non-recovered CA-AKI vs. no CA-AKI, HR = 1.39, 95% CI: 1.21–1.60, p & lt; 0.001]. In the subgroup of CAD, both recovered CA-AKI and non-recovered CA-AKI were associated with increased risk of long-term all-cause mortality. However, in other subgroup analyses, only non-recovered CA-AKI was associated with increased risk of long-term all-cause mortality. Conclusion Our results found that non-recovered CA-AKI is significantly associated with long-term mortality. In patients with CAD, recovered CA-AKI can still increase the risk of all-cause mortality. Clinicians need to pay more attention to patients suffering from CA-AKI, whose kidney function has not recovered. In addition, active prevention treatments should be taken by patients with CAD.
    Type of Medium: Online Resource
    ISSN: 2297-055X
    URL: Article
    DOI: 10.3389/fcvm.2022.823829
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
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  • 7
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    Table_1.XLSX
    Frontiers Media SA ; 2022
    In:  Frontiers in Cardiovascular Medicine Vol. 9 ( 2022-4-27)
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    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 9 ( 2022-4-27)
    Abstract: Different definitions of contrast-associated acute kidney injury (CA-AKI) have different predictive effects on prognosis. However, few studies explored the relationship between these definitions and long-term prognosis in patients with congestive heart failure (CHF). Thus, we aimed to evaluate this association and compared the population attributable risks (PAR) of different CA-AKI definitions. Methods This study enrolled 2,207 consecutive patients with CHF undergoing coronary angiography (CAG) in Guangdong Provincial People's Hospital. Two different definitions of CA-AKI were used: CA-AKI A was defined as an increase ≥.5 mg/dl or & gt; 25% in serum creatinine (SCr) from baseline within 72 h after CAG, and CA-AKI B was defined as an increase of ≥.3 mg/dl or & gt; 50% in SCr from baseline within 48 h after CAG. Kaplan-Meier methods and Cox regression were applied to evaluate the association between CA-AKI with long-term mortality. Population attributable risk (PAR) of different definitions for long-term prognosis was also calculated. Results During the 3.8-year median follow-up (interquartile range 2.1-6), the overall long-term mortality was 24.9%, and the long-term mortality in patients with the definitions of CA-AKI A and CA-AKI B were 30.4% and 34.3%, respectively. We found that CA-AKI A (HR: 1.44, 95% CI 1.19-1.74) and CA-AKI B (HR: 1.48, 95% CI 1.21-1.80) were associated with long-term mortality. The PAR was higher for CA-AKI A (9.6% vs. 8%). Conclusions Our findings suggested that CA-AKI was associated with long-term mortality in patients with CHF irrespective of its definitions. The CA-AKI A was a much better definition of CA-AKI in patients with CHF due to its higher PAR. For these patients, cardiologists should pay more attention to the presence of CA-AKI, especially CA-AKI A .
    Type of Medium: Online Resource
    ISSN: 2297-055X
    URL: Article
    URL: Article
    DOI: 10.3389/fcvm.2022.763656
    DOI: 10.3389/fcvm.2022.763656.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
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  • 8
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    Data_Sheet_1.docx
    Frontiers Media SA ; 2021
    In:  Frontiers in Cardiovascular Medicine Vol. 8 ( 2021-8-31)
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    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 8 ( 2021-8-31)
    Abstract: Background: A high level of lipoprotein(a) can lead to a high risk of cardiovascular events or mortality. However, the association of moderately elevated lipoprotein(a) levels (≥15 mg/dL) with long-term prognosis among patients with coronary artery disease (CAD) is still uncertain. Hence, we aim to systematically analyzed the relevance of baseline plasma lipoprotein(a) levels to long-term mortality in a large cohort of CAD patients. Methods: We obtained data from 43,647 patients who were diagnosed with CAD and had follow-up information from January 2007 to December 2018. The patients were divided into two groups ( & lt;15 and ≥15 mg/dL). The primary endpoint was long-term all-cause death. Kaplan–Meier curve analysis and Cox proportional hazards models were used to investigate the association between moderately elevated baseline lipoprotein(a) levels (≥15 mg/dL) and long-term all-cause mortality. Results: During a median follow-up of 5.04 years, 3,941 (18.1%) patients died. We observed a linear association between lipoprotein(a) levels and long-term all-cause mortality. Compared with lipoprotein(a) concentrations & lt;15 mg/dL, lipoprotein(a) ≥15 mg/dL was associated with a significantly higher risk of all-cause mortality [adjusted hazard ratio (aHR) 1.10, 95%CI: 1.04–1.16, P -values = 0.001). Similar results were found for the subgroup analysis of non-acute myocardial infarction, non-percutaneous coronary intervention, chronic heart failure, diabetes mellitus, or non-chronic kidney diseases. Conclusion: Moderately elevated baseline plasma lipoprotein(a) levels (≥15 mg/dL) are significantly associated with higher all-cause mortality in patients with CAD. Our finding provides a rationale for testing the lipoprotein(a)-reducing hypothesis with lower targets (even & lt;15 mg/dL) in CAD outcome trials.
    Type of Medium: Online Resource
    ISSN: 2297-055X
    URL: Article
    URL: Article
    DOI: 10.3389/fcvm.2021.670859
    DOI: 10.3389/fcvm.2021.670859.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
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  • 9
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    The global incidence and mortality of contrast-associated acute kidney injury following coronary angiography: a meta-analysis of 1.2 million patients
    Springer Science and Business Media LLC ; 2021
    In:  Journal of Nephrology Vol. 34, No. 5 ( 2021-10), p. 1479-1489
    Details
    In: Journal of Nephrology, Springer Science and Business Media LLC, Vol. 34, No. 5 ( 2021-10), p. 1479-1489
    Abstract: Contrast-associated acute kidney injury (CA-AKI) is a common complication after coronary angiography (CAG), which brings a poor prognosis. But up to now, there were fewer studies to discuss the incidence of CA-AKI comprehensively. We comprehensively explore the incidence of CA-AKI after coronary angiography. Methods We searched Medline, Embase, and Cochrane Database of Systematic Reviews (to 30th June 2019). We evaluated the world’s incidence of the CA-AKI, and associated mortality, and to described geographic variations according to countries, regions, and economies. CA-AKI was defined as an increase in serum creatinine ≥ 0.5 mg/dl or ≥ 25% within 72 h. Random effects model meta-analyses and meta-regressions was performed to derive the sources of heterogeneity. Results A total of 134 articles (1,211,106 participants) were included in our meta-analysis. Most studies originated from China, Japan, Turkey and United States, from upper middle income and high income countries. The pooled incidence of CA-AKI after coronary angiography was 12.8% (95% CI 11.7–13.9%), and the CA-AKI associated mortality was 20.2% (95% CI 10.7–29.7%). The incidence of CA-AKI and the CA-AKI associated mortality were not declined over time (Incidence rate change: 0.23% 95% CI − 0.050 to 0.510 p  = 0.617; Mortality rate change: − 1.05% 95% CI − 3.070 to 0.970 p  = 0.308, respectively). Conclusion CA-AKI was a universal complication in many regions, and the burden of CA-AKI remains severe. In clinical practice, physicians should pay more attention to the occurrence and active prevention and treatment of CA-AKI. Graphic abstract
    Type of Medium: Online Resource
    ISSN: 1121-8428 , 1724-6059
    URL: Article
    DOI: 10.1007/s40620-021-01021-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1475007-7
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  • 10
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    Predictive Value of Hypoalbuminemia for Contrast-Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis
    SAGE Publications ; 2021
    In:  Angiology Vol. 72, No. 7 ( 2021-08), p. 616-624
    Details
    In: Angiology, SAGE Publications, Vol. 72, No. 7 ( 2021-08), p. 616-624
    Abstract: Contrast-associated acute kidney injury (CA-AKI) is a major adverse complication of intravascular administration of contrast medium. Current studies have shown that hypoalbuminemia might be a novel risk factor of CA-AKI. This systematic review and meta-analysis was performed to evaluate the predictive value of hypoalbuminemia for CA-AKI. Relevant studies were identified in Ovid-Medline, PubMed, Embase, and Cochrane Library up to December 31, 2019. Two authors independently screened studies, consulting with a third author when necessary to resolve discrepancies. The pooled odds ratio (OR) was calculated to assess the association between hypoalbuminemia and CA-AKI using a random-effects model or fixed-effects model. Eight relevant studies involving a total of 18 687 patients met our inclusion criteria. The presence of hypoalbuminemia was associated with an increased risk of CA-AKI development (pooled OR: 2.59, 95% CI: 1.80-3.73). Hypoalbuminemia is independently associated with the occurrence of CA-AKI and may be a potentially modifiable factor for clinical intervention. This systematic review and meta-analysis was registered in PROSPERO (CRD42020168104).
    Type of Medium: Online Resource
    ISSN: 0003-3197 , 1940-1574
    URL: Article
    DOI: 10.1177/0003319721989185
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2065911-8
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