Abstract: SA-OR007
Renin-Angiotensin-Aldosterone System Blockade Is Associated with Higher Risk of Contrast-Induced AKI in Patients with Diabetes: A Multicenter Propensity Score-Matched Study
Session Information
- AKI: Onco-Nephrology and Other Drugs
November 09, 2019 | Location: Salon A/B, Walter E. Washington Convention Center
Abstract Time: 05:42 PM - 05:54 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Author
- Ma, Mengqing, Sir Run Run Hospital, Nanjing, China
Background
CIAKI is a relatively common complication after treatment of coronary angiography (CAG) and percutaneous coronary intervention (PCI). The role of ACEIs or ARBs on CIAKI is controversial.
Methods
A retrospective, multi-center design with propensity score matching (PSM) was used to evaluate the effect of ACEIs/ARBs on the occurrence of CIAKI in diabetic patients undergoing CAG and PCI. The primary endpoint CIAKI was defined as an increased serum creatinine level of ≥ 25% or 44 μmol/l (0.5mg/dl) over the baseline level within 72 hours after contrast agent exposed.
Results
A total of 2240 patients from four centers met the inclusion criteria. On the basis of PSM, 704 patients with ACEIs/ARBs were successfully matched to the control group. The incidence of CIAKI in the ACEIs/ARBs group was significantly higher than that in the control group (26.6%vs.16.2%, P< 0.001), no matter which kind of medicine was used in subgroups. In-hospital endpoints, patients with CIAKI had a higher risk of worsening heart failure (2.3% vs. 1.0%, P= 0.068). However, patients in the control group had an increased risk of overall adverse cardiovascular events (death, myocardial infarction, worsening heart failure, stroke) after PCI (3.8% vs. 1.8%, P= 0.034).
Conclusion
The ACEI/ARB was associated with an increased risk of CIAKI in patients with diabetes, but beneficial for early cardiovascular outcomes.