Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun;70(2):107-111.
doi: 10.1016/j.ehj.2017.12.004. Epub 2017 Dec 27.

Prevention of contrast induced nephropathy by ischemic preconditioning in patients undergoing percutaneous coronary angiography

Ahmed Shawky Elserafy  1 , Nireen Okasha  1 , Tamim Hegazy  1
Affiliations

Prevention of contrast induced nephropathy by ischemic preconditioning in patients undergoing percutaneous coronary angiography

Ahmed Shawky Elserafy et al. Egypt Heart J. 2018 Jun.

Abstract

Background: Contrast-induced nephropathy (CIN) is the acute deterioration of renal function after parenteral administration of radio contrast media in the absence of other causes. The true incidence of CIN varies because of differences among the published studies in the definition of CIN, the proportion of high-risk patients, the types of contrast media, and the use of preventive measures. Remote ischemic preconditioning (IPC) may offer a non-pharmacological prevention strategy for lowering CIN in patients undergoing coronary procedures. The assumption that IPC produces protective effects on tissues or organs by multiple brief cycles of ischemia and reperfusion applied to another remote tissue or organ.

Aim: To investigate the effect of ischemic preconditioning in prevention of CIN in patients with renal impairment undergoing percutaneous coronary angiography.

Results: In this study, 100 patients undergoing elective PCI with a base line creatinine clearance <60 ml/min were studied. Patients were divided into two equal groups (ischemic preconditioning group and control group). The incidence of CIN was markedly lower in ischemic preconditioning group 14% VS 38% in control group. The incidence of CIN difference as was found to be (24%). Amount of dye used, decreased LVEF and presence of a significant LAD lesion were significant risk factors for occurrence of CIN.

Conclusions: The current study showed that remote ischemic preconditioning plays an important role in prevention of CIN in patients undergoing PCI with renal impairment GFR < 60 ml/min. The amount of contrast, decreased LVEF, and presence of LAD significant lesion were significant risk factors for developing of CIN and these subgroups benefited from application of ischemic preconditioning.

Keywords: Contrast induced nephropathy; Coronary angiography; Ischemic preconditioning.

PubMed Disclaimer

References

    1. Rihal C.S., Textor S.C., Grill D.E. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation. 2002;105:2259–2264. - PubMed
    1. Best P.J.M., Lennon R., Ting H.H. The impact of renal insufficiency on clinical outcomes in patients undergoing percutaneous coronary interventions. J Am Coll Cardiol. 2002;39:1113–1119. - PubMed
    1. Gruberg L., Mintz G.S., Mehran R., Gangas G., Lansky A.J., Kent K.M. The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. J Am Coll Cardiol. 2000;36:1542–1548. - PubMed
    1. McCullough P.A., Adam A., Becker C.R., Davidson C., Lameire N., Stacul F. Risk prediction of contrast-induced nephropathy. Am J Cardiol. 2006;98:27K–36K. - PubMed
    1. Ali Z.A., Callaghan C.J., Lim E., Ali A.A., Nouraei S.A., Akthar A.M. Remote ischemic preconditioning reduces myocardial and renal injury after elective abdominal aortic aneurysm repair: a randomized controlled trial. Circulation. 2007;116(Suppl):I98–I105. - PubMed

LinkOut - more resources