Association of contrast-induced nephropathy with risk of adverse clinical outcomes in patients with cardiac catheterization

From the CINC-J study

on behalf of the CINC-J study investigators

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background The association between the incidence of contrast-induced nephropathy (CIN) and subsequent clinical outcomes is unclear in Japan. We evaluated the association between CIN and cardiovascular and renal events after cardiac catheterization. Methods The CINC-J multicenter prospective cohort study examined 853 patients undergoing cardiac catheterization from 27 hospitals. CIN was defined as increase in serum creatinine (SCr) ≥ 0.5 mg/dL or ≥ 25% from baseline between 48 and 72 h after exposure to contrast. Major adverse cardiovascular and cerebrovascular events (MACCE) included all-cause deaths, non-fatal myocardial infarction, acute decompensated heart failure (ADHF), and stroke. Renal events included newly-required hemodialysis and increase of SCr ≥ 2 × from baseline. Results During follow-up periods (477 ± 214 days), CIN, MACCE, and renal events occurred in 44 (5.2%), 71 (8.3%), and 26 (3.0%) patients, respectively. Kaplan–Meier analysis showed that CIN yielded increasing risk for MACCE, ADHF, newly-required hemodialysis, and renal events. In multivariable Cox proportional hazards analysis, age (HR: 1.03; 95% CI, 1.00–1.07; P = 0.0425), anemia (HR: 1.94; 95% CI, 1.08–3.61; P = 0.0264), and diabetes mellitus (HR: 1.86; 95% CI, 1.10–3.21; P = 0.0119) were independent predictors of MACCE, whereas CIN (HR: 7.78; 95% CI, 3.23–17.9; P = 0.0005) and SCr (HR: 2.09; 95% CI, 1.56–2.73; P = 0.0006) were independent predictors of renal events. Compared to subjects without both anemia and CIN as the reference, those with both were high risk for MACCE (HR: 3.97; 95% CI, 1.25–10.6; P = 0.0218). Conclusion CIN was a significant predictor of subsequent renal events after cardiac catheterization. CIN and anemia were associated with increased risk for worse long-term clinical outcome, especially when both were present.

Original languageEnglish
Pages (from-to)424-429
Number of pages6
JournalInternational Journal of Cardiology
Volume227
DOIs
Publication statusPublished - Jan 15 2017
Externally publishedYes

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Cardiac Catheterization
Kidney
Anemia
Renal Dialysis
Creatinine
Heart Failure
Serum
Cause of Death
Diabetes Mellitus
Japan
Cohort Studies
Stroke
Myocardial Infarction
Prospective Studies
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Association of contrast-induced nephropathy with risk of adverse clinical outcomes in patients with cardiac catheterization : From the CINC-J study. / on behalf of the CINC-J study investigators.

In: International Journal of Cardiology, Vol. 227, 15.01.2017, p. 424-429.

Research output: Contribution to journalArticle

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title = "Association of contrast-induced nephropathy with risk of adverse clinical outcomes in patients with cardiac catheterization: From the CINC-J study",
abstract = "Background The association between the incidence of contrast-induced nephropathy (CIN) and subsequent clinical outcomes is unclear in Japan. We evaluated the association between CIN and cardiovascular and renal events after cardiac catheterization. Methods The CINC-J multicenter prospective cohort study examined 853 patients undergoing cardiac catheterization from 27 hospitals. CIN was defined as increase in serum creatinine (SCr) ≥ 0.5 mg/dL or ≥ 25{\%} from baseline between 48 and 72 h after exposure to contrast. Major adverse cardiovascular and cerebrovascular events (MACCE) included all-cause deaths, non-fatal myocardial infarction, acute decompensated heart failure (ADHF), and stroke. Renal events included newly-required hemodialysis and increase of SCr ≥ 2 × from baseline. Results During follow-up periods (477 ± 214 days), CIN, MACCE, and renal events occurred in 44 (5.2{\%}), 71 (8.3{\%}), and 26 (3.0{\%}) patients, respectively. Kaplan–Meier analysis showed that CIN yielded increasing risk for MACCE, ADHF, newly-required hemodialysis, and renal events. In multivariable Cox proportional hazards analysis, age (HR: 1.03; 95{\%} CI, 1.00–1.07; P = 0.0425), anemia (HR: 1.94; 95{\%} CI, 1.08–3.61; P = 0.0264), and diabetes mellitus (HR: 1.86; 95{\%} CI, 1.10–3.21; P = 0.0119) were independent predictors of MACCE, whereas CIN (HR: 7.78; 95{\%} CI, 3.23–17.9; P = 0.0005) and SCr (HR: 2.09; 95{\%} CI, 1.56–2.73; P = 0.0006) were independent predictors of renal events. Compared to subjects without both anemia and CIN as the reference, those with both were high risk for MACCE (HR: 3.97; 95{\%} CI, 1.25–10.6; P = 0.0218). Conclusion CIN was a significant predictor of subsequent renal events after cardiac catheterization. CIN and anemia were associated with increased risk for worse long-term clinical outcome, especially when both were present.",
author = "{on behalf of the CINC-J study investigators} and Akira Sato and Kazutaka Aonuma and Makoto Watanabe and Atsushi Hirayama and Nagara Tamaki and Hiroyuki Tsutsui and Murohara Toyoaki and Hisao Ogawa and Takashi Akasaka and Michihiro Yoshimura and Tadateru Takayama and Mamoru Sakakibara and Susumu Suzuki and Kenichi Ishigami and Kenji Onoue and Yoshihiko Saito",
year = "2017",
month = "1",
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doi = "10.1016/j.ijcard.2016.11.019",
language = "English",
volume = "227",
pages = "424--429",
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TY - JOUR

T1 - Association of contrast-induced nephropathy with risk of adverse clinical outcomes in patients with cardiac catheterization

T2 - From the CINC-J study

AU - on behalf of the CINC-J study investigators

AU - Sato, Akira

AU - Aonuma, Kazutaka

AU - Watanabe, Makoto

AU - Hirayama, Atsushi

AU - Tamaki, Nagara

AU - Tsutsui, Hiroyuki

AU - Toyoaki, Murohara

AU - Ogawa, Hisao

AU - Akasaka, Takashi

AU - Yoshimura, Michihiro

AU - Takayama, Tadateru

AU - Sakakibara, Mamoru

AU - Suzuki, Susumu

AU - Ishigami, Kenichi

AU - Onoue, Kenji

AU - Saito, Yoshihiko

PY - 2017/1/15

Y1 - 2017/1/15

N2 - Background The association between the incidence of contrast-induced nephropathy (CIN) and subsequent clinical outcomes is unclear in Japan. We evaluated the association between CIN and cardiovascular and renal events after cardiac catheterization. Methods The CINC-J multicenter prospective cohort study examined 853 patients undergoing cardiac catheterization from 27 hospitals. CIN was defined as increase in serum creatinine (SCr) ≥ 0.5 mg/dL or ≥ 25% from baseline between 48 and 72 h after exposure to contrast. Major adverse cardiovascular and cerebrovascular events (MACCE) included all-cause deaths, non-fatal myocardial infarction, acute decompensated heart failure (ADHF), and stroke. Renal events included newly-required hemodialysis and increase of SCr ≥ 2 × from baseline. Results During follow-up periods (477 ± 214 days), CIN, MACCE, and renal events occurred in 44 (5.2%), 71 (8.3%), and 26 (3.0%) patients, respectively. Kaplan–Meier analysis showed that CIN yielded increasing risk for MACCE, ADHF, newly-required hemodialysis, and renal events. In multivariable Cox proportional hazards analysis, age (HR: 1.03; 95% CI, 1.00–1.07; P = 0.0425), anemia (HR: 1.94; 95% CI, 1.08–3.61; P = 0.0264), and diabetes mellitus (HR: 1.86; 95% CI, 1.10–3.21; P = 0.0119) were independent predictors of MACCE, whereas CIN (HR: 7.78; 95% CI, 3.23–17.9; P = 0.0005) and SCr (HR: 2.09; 95% CI, 1.56–2.73; P = 0.0006) were independent predictors of renal events. Compared to subjects without both anemia and CIN as the reference, those with both were high risk for MACCE (HR: 3.97; 95% CI, 1.25–10.6; P = 0.0218). Conclusion CIN was a significant predictor of subsequent renal events after cardiac catheterization. CIN and anemia were associated with increased risk for worse long-term clinical outcome, especially when both were present.

AB - Background The association between the incidence of contrast-induced nephropathy (CIN) and subsequent clinical outcomes is unclear in Japan. We evaluated the association between CIN and cardiovascular and renal events after cardiac catheterization. Methods The CINC-J multicenter prospective cohort study examined 853 patients undergoing cardiac catheterization from 27 hospitals. CIN was defined as increase in serum creatinine (SCr) ≥ 0.5 mg/dL or ≥ 25% from baseline between 48 and 72 h after exposure to contrast. Major adverse cardiovascular and cerebrovascular events (MACCE) included all-cause deaths, non-fatal myocardial infarction, acute decompensated heart failure (ADHF), and stroke. Renal events included newly-required hemodialysis and increase of SCr ≥ 2 × from baseline. Results During follow-up periods (477 ± 214 days), CIN, MACCE, and renal events occurred in 44 (5.2%), 71 (8.3%), and 26 (3.0%) patients, respectively. Kaplan–Meier analysis showed that CIN yielded increasing risk for MACCE, ADHF, newly-required hemodialysis, and renal events. In multivariable Cox proportional hazards analysis, age (HR: 1.03; 95% CI, 1.00–1.07; P = 0.0425), anemia (HR: 1.94; 95% CI, 1.08–3.61; P = 0.0264), and diabetes mellitus (HR: 1.86; 95% CI, 1.10–3.21; P = 0.0119) were independent predictors of MACCE, whereas CIN (HR: 7.78; 95% CI, 3.23–17.9; P = 0.0005) and SCr (HR: 2.09; 95% CI, 1.56–2.73; P = 0.0006) were independent predictors of renal events. Compared to subjects without both anemia and CIN as the reference, those with both were high risk for MACCE (HR: 3.97; 95% CI, 1.25–10.6; P = 0.0218). Conclusion CIN was a significant predictor of subsequent renal events after cardiac catheterization. CIN and anemia were associated with increased risk for worse long-term clinical outcome, especially when both were present.

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U2 - 10.1016/j.ijcard.2016.11.019

DO - 10.1016/j.ijcard.2016.11.019

M3 - Article

VL - 227

SP - 424

EP - 429

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -