European Radiology, Journal Year: 2023, Volume and Issue: 33(12), P. 9444 - 9454
Published: July 22, 2023
Language: Английский
European Heart Journal, Journal Year: 2024, Volume and Issue: 45(18), P. 1647 - 1658
Published: March 21, 2024
Contrast-induced nephropathy (CIN), also known as contrast-associated acute kidney injury (CA-AKI) underlies a significant proportion of the morbidity and mortality following coronary angiographic procedures in high-risk patients remains unmet need. In pre-clinical studies inorganic nitrate, which is chemically reduced vivo to nitric oxide, renoprotective but this observation yet be translated clinically. study, efficacy nitrate prevention CIN presenting with syndromes (ACS) reported.
Language: Английский
Citations
19
Circulation, Journal Year: 2023, Volume and Issue: 148(18), P. 1371 - 1380
Published: Sept. 29, 2023
BACKGROUND: Patients with previous coronary artery bypass grafting often require invasive angiography (ICA). However, for these patients, the procedure is technically more challenging and has a higher risk of complications. Observational studies suggest that computed tomography cardiac (CTCA) may facilitate ICA in this group, but not been tested randomized controlled trial. METHODS: This study was single-center, open-label trial assessing benefit adjunctive CTCA patients referred ICA. were 1:1 to undergo before or alone. The co–primary end points procedural duration (defined as interval between local anesthesia administration obtaining vascular access removal last catheter), patient satisfaction after using validated questionnaire, incidence contrast-induced nephropathy. Linear regression used score; nephropathy analyzed logistic regression. We applied Bonferroni correction, P <0.017 considered significant 98.33% CIs presented. Secondary included complications 1-year major adverse events. RESULTS: Over 3 years, 688 median follow-up 1.0 years. mean age 69.8±10.4 108 (15.7%) women, 402 (58.4%) White, there high burden comorbidity (85.3% hypertension 53.8% diabetes). time from 12.0 (interquartile range, 2 3) grafts per participant. Procedure significantly shorter CTCA+ICA group (CTCA+ICA, 18.6±9.5 minutes versus alone, 39.5±16.9 [98.33% CI, −23.5 −18.4]; <0.001), alongside improved scores (1=very good 5=very poor; −1.1 difference −1.2 −0.9]; reduced (3.4% 27.9%; odds ratio, 0.09 0.04–0.2]; <0.001). Procedural (2.3% 10.8%; 0.2 [95% 0.1–0.4]; <0.001) events (16.0% 29.4%; hazard 0.4 0.3–0.6]; also lower group. CONCLUSIONS: For grafting, leads reductions nephropathy, satisfaction. should be patients. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03736018.
Language: Английский
Citations
28
КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2023, Volume and Issue: 16(12), P. 1503 - 1513
Published: June 1, 2023
Language: Английский
Citations
12
Revista Española de Cardiología (English Edition), Journal Year: 2024, Volume and Issue: 77(8), P. 607 - 617
Published: Aug. 1, 2024
Citations
4
Journal of cardiovascular computed tomography, Journal Year: 2024, Volume and Issue: 18(3), P. 291 - 296
Published: March 11, 2024
Language: Английский
Citations
3
PLoS ONE, Journal Year: 2024, Volume and Issue: 19(10), P. e0312618 - e0312618
Published: Oct. 24, 2024
We developed a comprehensive kidney protection strategy (KPS), which comprises left ventricular end-diastolic pressure-guided saline hydration, ultralow contrast coronary angiography, and staged revascularization procedure under suitable conditions. This study aimed to investigate KPS’s effect on the risk of developing contrast-associated acute injury (CA-AKI) among persons with moderate-to-advanced insufficiency (KI). Seventy patients who had undergone cardiac catheterization an estimated glomerular filtration rate (eGFR) 15–45 mL/min/1.73 m 2 were investigated retrospectively. Among these, 19 received KPS 51 usual care (UC) enrolled. CA-AKI was defined as 0.3-mg/dL increase in serum creatinine levels or dialysis initiation within 72 h after exposure. The inverse probability treatment weighting (IPTW)-adjusted cohort analyzed according Mehran categories. Patients’ mean age 73.3 ± 9.6 years; eGFR 29.8 8.5 ; median score, 8. Most presented myocardial infarction (AMI) heart failure, one-fifth administered catheterizations emergency procedures. After IPTW adjustment, group showed significantly lower than UC (4% vs. 20.4%; odds ratio 0.19, 95% confidence interval 0.05–0.66). consistent across various subgroups different variables, including old age, AMI, advanced KI, high-risk category, systolic dysfunction, multivessel disease. Conclusively, may reduce KI have catheterization.
Language: Английский
Citations
3
КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2025, Volume and Issue: 18(4), P. 409 - 424
Published: Feb. 1, 2025
Since its inception, percutaneous coronary intervention (PCI) has relied upon vessel opacification with iodinated contrast to plan, guide, and assess the results of procedure. Yet revisiting this fundamental concept is important in contemporary PCI practice, especially patients high-risk clinical or anatomical profiles. In addition decreasing probability acute kidney injury during PCI, limiting volume allows operator perform more thorough interventions by relying on intracoronary imaging physiology, ultimately contributing complete revascularization improving efficacy durability intervention. Ultra-low-contrast (ULCPCI) may thus be useful performing not only chronic renal dysfunction but also those multivessel artery disease, impaired left ventricular function, many other scenarios. The aim review highlight scenarios which a ULCPCI approach beneficial. authors provide structured address challenges faced operators transitioning from conventional contrast-based ULCPCI, practical solutions that are accessible most interventionalists. reader will learn feasible practice as result technological innovation, implementation dedicated skills, redefining role angiography cornerstone PCI.
Language: Английский
Citations
0
BMC Cardiovascular Disorders, Journal Year: 2025, Volume and Issue: 25(1)
Published: Feb. 25, 2025
Contrast-induced nephropathy (CIN) is a significant complication in acute coronary syndrome (ACS) patients undergoing percutaneous intervention (PCI). The role of the stress hyperglycemia ratio (SHR) as predictor CIN and mortality these remains unclear warrants investigation. To assess relationship between SHR CIN, well its impact on short-term ACS PCI. We conducted retrospective cohort study using MIMIC-IV database, including 552 patients. was calculated admission glucose to estimated average from hemoglobin A1c. defined ≥ 0.5 mg/dL or 25% increase serum creatinine within 48 h Logistic regression spline models were used analyze association while Kaplan–Meier curves assessed 30-day mortality. Higher levels independently associated with increased risk (OR 2.36, 95% CI: 1.56–3.57, P < 0.0001). A J-shaped observed, rising sharply when exceeded 1.06. also higher (P Subgroup analysis revealed stronger SHR-CIN non-diabetic an independent It offers potential for stratification clinical decision-making, especially
Language: Английский
Citations
0
Angiology, Journal Year: 2025, Volume and Issue: unknown
Published: April 25, 2025
The aim of this review was to systematically published studies on risk prediction models for contrast-associated acute kidney injury (CA-AKI) in patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). We searched PubMed, Embase, Web Science, Scopus, Medline, Cumulative Index Nursing and Allied Health Literature (CINAHL), Chinese databases from inception July 1, 2024. Checklist critical Appraisal data extraction systematic Reviews Modelling Studies (CHARMS) used extract Prediction Model Risk Bias Assessment Tool (PROBAST) assess the bias applicability. A total 2784 publications were retrieved; 16 included. models’ area under curve (AUC) or C-index ranged 0.719 0.877. Commonly predictors included age, diabetes, Killip class, use intra-aortic balloon pump (IABP). Thirteen determined be at high bias, while three unclear, but their applicability satisfactory. clinical utility still up debate. Future development validation should focus methodology combine machine learning natural language processing analyze improve predictive ability models.
Language: Английский
Citations
0
Mayo Clinic Proceedings, Journal Year: 2025, Volume and Issue: unknown
Published: June 1, 2025
Language: Английский
Citations
0