Clinical StudiesAcute Renal Failure After Coronary Intervention: Incidence, Risk Factors, and Relationship to Mortality
Section snippets
Study Sample
This study was approved by the Human Investigations Committee at William Beaumont Hospital, a 929 bed tertiary care center. A total of 2,206 consecutive coronary interventional procedures (balloon angioplasty, atherectomy, stenting) at our institution were screened from December 1993 to August 1994. Twenty-four patients previously on dialysis were excluded. Repeated procedures within the study period (n = 356) were also excluded. The final cohort of 1,826 had one procedure per patient
Results
Baseline characteristics of the derivation set subdivided by diabetic status are listed in Table 1. The contrast agents used were diatrizoate (Hypaque) in 1,002 patients (54.9%), ioxaglate meglumine (Hexabrix) in 601 (33.0%), and both in 223 (12.0%). Doses of contrast ranged from 24.0 mL to 835.0 mL. Preprocedure serum creatinine values were available in 1,799 cases (98.5%) and at least one postprocedure creatinine was available in 1790 (98.0%). In no case were both pre- and postprocedure
Discussion
Ten million intravascular contrast procedures are performed in the United States per year, 400,000 of which are coronary interventions.43, 47The present study has outlined, in a large cohort of coronary intervention patients, the risks of ARF and ARFD in terms of absolute and validated prospective probabilities. Furthermore, the fatal associations between ARF and ARFD in terms of short-term mortality and long-term survival have been demonstrated. These associations have been found similarly in
Acknowledgements
We are indebted to Gerald C. Timmis, MD, for his support and critical review of this work.
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