Statins and Contrast-induced Acute Kidney Injury with Coronary Angiography
Abstract Background Contrast-induced acute kidney injury is an adverse outcome resulting from radiocontrast medium exposure during coronary angiography and percutaneous coronary intervention. Methods A systematic search was conducted to retrieve studies that investigated the impact of statin exposur...
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| Veröffentlicht in: | The American journal of medicine 2014-10, Vol.127 (10), p.987-1000 |
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| creator | Gandhi, Sumeet, MD Mosleh, Wassim, (Hon) BSc Abdel-Qadir, Husam, MD Farkouh, Michael E., MD, MSc |
| description | Abstract Background Contrast-induced acute kidney injury is an adverse outcome resulting from radiocontrast medium exposure during coronary angiography and percutaneous coronary intervention. Methods A systematic search was conducted to retrieve studies that investigated the impact of statin exposure before coronary angiography or percutaneous coronary intervention on the development of contrast-induced acute kidney injury. The primary outcome was the development of contrast-induced acute kidney injury. We separately analyzed statin/placebo comparisons and high-/low-dose statin comparisons. Results Fifteen randomized controlled trials met inclusion criteria: 11 studies with statin-naïve subjects, 2 studies with chronic statin users, and 2 studies with unspecified prior statin exposure. Statin exposure reduced the risk of contrast-induced acute kidney injury relative to placebo (relative risk [RR] 0.63, P = .01) with a nonsignificant reduction in the need for hemodialysis (RR 0.25, P = .08). This benefit was also observed in high-dose versus low-dose statin trials (RR 0.46, P = .004), in statin-naïve patients (RR 0.53, P |
| doi_str_mv | 10.1016/j.amjmed.2014.05.011 |
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Methods A systematic search was conducted to retrieve studies that investigated the impact of statin exposure before coronary angiography or percutaneous coronary intervention on the development of contrast-induced acute kidney injury. The primary outcome was the development of contrast-induced acute kidney injury. We separately analyzed statin/placebo comparisons and high-/low-dose statin comparisons. Results Fifteen randomized controlled trials met inclusion criteria: 11 studies with statin-naïve subjects, 2 studies with chronic statin users, and 2 studies with unspecified prior statin exposure. Statin exposure reduced the risk of contrast-induced acute kidney injury relative to placebo (relative risk [RR] 0.63, P = .01) with a nonsignificant reduction in the need for hemodialysis (RR 0.25, P = .08). This benefit was also observed in high-dose versus low-dose statin trials (RR 0.46, P = .004), in statin-naïve patients (RR 0.53, P <.0001), and with all studied statins. Higher statin exposure reduced contrast-induced acute kidney injury in patients with acute coronary syndromes compared with placebo or low-dose statins (RR 0.49, P <.00001), with no significant benefit among patients undergoing elective procedures (RR 0.86, P = .50). Subgroup analyses confirmed the benefit of statins in patients with diabetes, chronic kidney disease, congestive heart failure, and those receiving >140 mL of contrast dye. Conclusion Statin therapy is effective at reducing the risk of contrast-induced acute kidney injury. It should thus be considered, at least on a short-term basis, for patients at increased risk of this complication.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/j.amjmed.2014.05.011</identifier><identifier>PMID: 24852935</identifier><identifier>CODEN: AJMEAZ</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute Kidney Injury - chemically induced ; Acute Kidney Injury - prevention & control ; angiogram ; Angioplasty ; atorvastatin ; CIN ; Clinical trials ; Contrast Media - adverse effects ; contrast-induced acute kidney injury ; contrast-induced nephropathy ; coronary angiography ; Coronary Angiography - adverse effects ; Databases, Bibliographic ; Diabetes Complications ; Heart Failure - complications ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Internal Medicine ; Kidney diseases ; Medical imaging ; PCI ; percutaneous coronary intervention ; Percutaneous Coronary Intervention - adverse effects ; Protective Factors ; Renal Insufficiency, Chronic - complications ; Risk Factors ; rosuvastatin ; simvastatin ; Statins</subject><ispartof>The American journal of medicine, 2014-10, Vol.127 (10), p.987-1000</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Oct 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-58897855419b3e1abdbe9965d66de3086b3bc7a2e2e447d4394f5c38a0f67eaf3</citedby><cites>FETCH-LOGICAL-c445t-58897855419b3e1abdbe9965d66de3086b3bc7a2e2e447d4394f5c38a0f67eaf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjmed.2014.05.011$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24852935$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gandhi, Sumeet, MD</creatorcontrib><creatorcontrib>Mosleh, Wassim, (Hon) BSc</creatorcontrib><creatorcontrib>Abdel-Qadir, Husam, MD</creatorcontrib><creatorcontrib>Farkouh, Michael E., MD, MSc</creatorcontrib><title>Statins and Contrast-induced Acute Kidney Injury with Coronary Angiography</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>Abstract Background Contrast-induced acute kidney injury is an adverse outcome resulting from radiocontrast medium exposure during coronary angiography and percutaneous coronary intervention. Methods A systematic search was conducted to retrieve studies that investigated the impact of statin exposure before coronary angiography or percutaneous coronary intervention on the development of contrast-induced acute kidney injury. The primary outcome was the development of contrast-induced acute kidney injury. We separately analyzed statin/placebo comparisons and high-/low-dose statin comparisons. Results Fifteen randomized controlled trials met inclusion criteria: 11 studies with statin-naïve subjects, 2 studies with chronic statin users, and 2 studies with unspecified prior statin exposure. Statin exposure reduced the risk of contrast-induced acute kidney injury relative to placebo (relative risk [RR] 0.63, P = .01) with a nonsignificant reduction in the need for hemodialysis (RR 0.25, P = .08). This benefit was also observed in high-dose versus low-dose statin trials (RR 0.46, P = .004), in statin-naïve patients (RR 0.53, P <.0001), and with all studied statins. Higher statin exposure reduced contrast-induced acute kidney injury in patients with acute coronary syndromes compared with placebo or low-dose statins (RR 0.49, P <.00001), with no significant benefit among patients undergoing elective procedures (RR 0.86, P = .50). Subgroup analyses confirmed the benefit of statins in patients with diabetes, chronic kidney disease, congestive heart failure, and those receiving >140 mL of contrast dye. Conclusion Statin therapy is effective at reducing the risk of contrast-induced acute kidney injury. It should thus be considered, at least on a short-term basis, for patients at increased risk of this complication.</description><subject>Acute Kidney Injury - chemically induced</subject><subject>Acute Kidney Injury - prevention & control</subject><subject>angiogram</subject><subject>Angioplasty</subject><subject>atorvastatin</subject><subject>CIN</subject><subject>Clinical trials</subject><subject>Contrast Media - adverse effects</subject><subject>contrast-induced acute kidney injury</subject><subject>contrast-induced nephropathy</subject><subject>coronary angiography</subject><subject>Coronary Angiography - adverse effects</subject><subject>Databases, Bibliographic</subject><subject>Diabetes Complications</subject><subject>Heart Failure - complications</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</subject><subject>Internal Medicine</subject><subject>Kidney diseases</subject><subject>Medical imaging</subject><subject>PCI</subject><subject>percutaneous coronary intervention</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Protective Factors</subject><subject>Renal Insufficiency, Chronic - complications</subject><subject>Risk Factors</subject><subject>rosuvastatin</subject><subject>simvastatin</subject><subject>Statins</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1v1DAQhi0EokvhHyAUiQuXBH8nviCtVqUUKnEonC3HnrQOWWexnaL99zjaVki9cLJGfua15xmE3hLcEEzkx7Ex-3EPrqGY8AaLBhPyDG2IEKJuiaTP0QZjTGvFODtDr1IaS4mVkC_RGeWdoIqJDfp6k032IVUmuGo3hxxNyrUPbrHgqq1dMlTfvAtwrK7CuMRj9cfnu0LGOZhSbcOtn2-jOdwdX6MXg5kSvHk4z9HPzxc_dl_q6--XV7vtdW05F7kWXafaTghOVM-AmN71oJQUTkoHDHeyZ71tDQUKnLeOM8UHYVln8CBbMAM7Rx9OuYc4_14gZb33ycI0mQDzkjSRhNJOtoIU9P0TdJyXGMrvCkW5KpCgheInysY5pQiDPkS_L9NpgvXqWo_65FqvrjUWurgube8ewpd-vXtsepRbgE8nAIqNew9RJ-shFLE-gs3azf5_LzwNsJMP3prpFxwh_ZtFJ6qxvln3va6bcIyZajH7C2KwpSw</recordid><startdate>20141001</startdate><enddate>20141001</enddate><creator>Gandhi, Sumeet, MD</creator><creator>Mosleh, Wassim, (Hon) BSc</creator><creator>Abdel-Qadir, Husam, MD</creator><creator>Farkouh, Michael E., MD, MSc</creator><general>Elsevier Inc</general><general>Elsevier Sequoia S.A</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20141001</creationdate><title>Statins and Contrast-induced Acute Kidney Injury with Coronary Angiography</title><author>Gandhi, Sumeet, MD ; Mosleh, Wassim, (Hon) BSc ; Abdel-Qadir, Husam, MD ; Farkouh, Michael E., MD, MSc</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-58897855419b3e1abdbe9965d66de3086b3bc7a2e2e447d4394f5c38a0f67eaf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Acute Kidney Injury - chemically induced</topic><topic>Acute Kidney Injury - prevention & control</topic><topic>angiogram</topic><topic>Angioplasty</topic><topic>atorvastatin</topic><topic>CIN</topic><topic>Clinical trials</topic><topic>Contrast Media - adverse effects</topic><topic>contrast-induced acute kidney injury</topic><topic>contrast-induced nephropathy</topic><topic>coronary angiography</topic><topic>Coronary Angiography - adverse effects</topic><topic>Databases, Bibliographic</topic><topic>Diabetes Complications</topic><topic>Heart Failure - complications</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</topic><topic>Internal Medicine</topic><topic>Kidney diseases</topic><topic>Medical imaging</topic><topic>PCI</topic><topic>percutaneous coronary intervention</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Protective Factors</topic><topic>Renal Insufficiency, Chronic - complications</topic><topic>Risk Factors</topic><topic>rosuvastatin</topic><topic>simvastatin</topic><topic>Statins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gandhi, Sumeet, MD</creatorcontrib><creatorcontrib>Mosleh, Wassim, (Hon) BSc</creatorcontrib><creatorcontrib>Abdel-Qadir, Husam, MD</creatorcontrib><creatorcontrib>Farkouh, Michael E., MD, MSc</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gandhi, Sumeet, MD</au><au>Mosleh, Wassim, (Hon) BSc</au><au>Abdel-Qadir, Husam, MD</au><au>Farkouh, Michael E., MD, MSc</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Statins and Contrast-induced Acute Kidney Injury with Coronary Angiography</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>2014-10-01</date><risdate>2014</risdate><volume>127</volume><issue>10</issue><spage>987</spage><epage>1000</epage><pages>987-1000</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>Abstract Background Contrast-induced acute kidney injury is an adverse outcome resulting from radiocontrast medium exposure during coronary angiography and percutaneous coronary intervention. Methods A systematic search was conducted to retrieve studies that investigated the impact of statin exposure before coronary angiography or percutaneous coronary intervention on the development of contrast-induced acute kidney injury. The primary outcome was the development of contrast-induced acute kidney injury. We separately analyzed statin/placebo comparisons and high-/low-dose statin comparisons. Results Fifteen randomized controlled trials met inclusion criteria: 11 studies with statin-naïve subjects, 2 studies with chronic statin users, and 2 studies with unspecified prior statin exposure. Statin exposure reduced the risk of contrast-induced acute kidney injury relative to placebo (relative risk [RR] 0.63, P = .01) with a nonsignificant reduction in the need for hemodialysis (RR 0.25, P = .08). This benefit was also observed in high-dose versus low-dose statin trials (RR 0.46, P = .004), in statin-naïve patients (RR 0.53, P <.0001), and with all studied statins. Higher statin exposure reduced contrast-induced acute kidney injury in patients with acute coronary syndromes compared with placebo or low-dose statins (RR 0.49, P <.00001), with no significant benefit among patients undergoing elective procedures (RR 0.86, P = .50). Subgroup analyses confirmed the benefit of statins in patients with diabetes, chronic kidney disease, congestive heart failure, and those receiving >140 mL of contrast dye. Conclusion Statin therapy is effective at reducing the risk of contrast-induced acute kidney injury. It should thus be considered, at least on a short-term basis, for patients at increased risk of this complication.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24852935</pmid><doi>10.1016/j.amjmed.2014.05.011</doi><tpages>14</tpages></addata></record> |
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| subjects | Acute Kidney Injury - chemically induced Acute Kidney Injury - prevention & control angiogram Angioplasty atorvastatin CIN Clinical trials Contrast Media - adverse effects contrast-induced acute kidney injury contrast-induced nephropathy coronary angiography Coronary Angiography - adverse effects Databases, Bibliographic Diabetes Complications Heart Failure - complications Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Internal Medicine Kidney diseases Medical imaging PCI percutaneous coronary intervention Percutaneous Coronary Intervention - adverse effects Protective Factors Renal Insufficiency, Chronic - complications Risk Factors rosuvastatin simvastatin Statins |
| title | Statins and Contrast-induced Acute Kidney Injury with Coronary Angiography |
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