Association between the risks of contrast-induced nephropathy after diagnostic or interventional coronary management and the transradial and transfemoral access approaches

Journal of Cardiovascular and Thoracic Research

Mohammad Javad Alemzadeh-Ansari¹  Farshad Shakerian¹  Reza Kiani¹  Naser Mohammadhadi¹  Raana Asghari¹  Simin Shokrollahi Yancheshmeh¹  Behshid Ghadrdoost¹  Mohammad Mehdi Peighambari¹  Ali Zahedmehr¹  Ata Firouzi¹  Hamid Reza Sanati¹  Alireza Rashidinejad¹  Bahram Mohebbi¹ 

[1] Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran;

关键词: contrast-induced nephropathy;    transfemoral access;    transradial access;    percutaneous coronary intervention;   

DOI  :  10.34172/jcvtr.2020.08

来源: DOAJ

【 摘 要 】

Introduction: The risk of contrast-induced nephropathy (CIN) as a common and important complication of coronary procedures may be influenced by the vascular access site. We compared the risks of CIN in diagnostic or interventional coronary management between patients treated via the transradial access (TRA) and those treated via the transfemoral access (TFA). Methods: Patients undergoing invasive coronary catheterization or percutaneous coronary intervention (PCI) were enrolled. We excluded patients with congenital or structural heart disease and those with end-stage renal disease on dialysis. Based on the vascular access site used for invasive coronary catheterization, the patients were divided into 2 study groups: the TFA and the TRA. CIN was defined as an absolute (≥0.5 mg/dL) or relative (>25%) increase in the baseline serum creatinine level within 48 hours following cardiac catheterization or PCI. Results: Overall, 410 patients (mean age = 61.3 ± 10.8 years) underwent diagnostic or interventional coronary management: 258 were treated via the TFA approach and 152 via the TRA approach. The patients treated via the TFA had a significantly higher incidence of postprocedural CIN (15.1% vs 6.6%; P = 0.01). The multivariate analysis showed that the TFA was the independent predictor of CIN (OR: 2.37, 95% CI: 1.11 to 5.10, and P = 0.027). Moreover, the BARC (Bleeding Academic Research Consortium) and Mehran scores were the other independent predictors of CIN in our study. Conclusion: The risk of CIN was lower with the TRA, and the TFA was the independent predictor of CIN after the diagnostic or interventional coronary management.

【 授权许可】

Unknown