Impact of periprocedural bleeding on incidence of contrast-induced acute kidney injury in patients treated with percutaneous coronary intervention

Yohei Ohno, Yuichiro Maekawa, Hiroaki Miyata, Soushin Inoue, Shiro Ishikawa, Koichiro Sueyoshi, Shigetaka Noma, Akio Kawamura, Shun Kosaka, Keiichi Fukuda

Research output: Contribution to journalArticle

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Abstract

Objectives This study sought to evaluate the association between contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention and severity of bleeding estimated from periprocedural hemoglobin (Hb) measurement. Background The relationship between CI-AKI and bleeding in contemporary practice remains controversial. Methods In a retrospective analysis of the prospectively maintained Japan Cardiovascular Database-Keio Interhospital Cardiovascular Studies (JCD-KICS) multicenter registry, we divided 2,646 consecutive patients into 5 groups according to the change of Hb level after compared with before percutaneous coronary intervention: Patients without a decrease in Hb level (group A) and patients with a decreased Hb level: <1 g/dl (group B); 1 to <2 g/dl (group C); 2 to <3g/dl (group D); and >3 g/dl (group E). CI-AKI was defined as an increase in serum creatinine level ≥0.5 mg/dl or ≥25% above baseline values at 48 h after administration of contrast media. Procedure and outcome variables were compared. Results The mean patient age was 67 ± 11 years. Of the 2,646 patients, CI-AKI developed in 315 (11.9%). The CI-AKI incidence was 6.2%, 7.5%, 10.7%, 17.0%, and 26.2%, in groups A through E, respectively (p < 0.01), whereas the incidence of major bleeding was 0.7%, 1.3%, 2.0%, 4.1%, and 28.3%, respectively (p < 0.01). CI-AKI was associated with higher rates of mortality (5.4% vs. 0.6%, p < 0.01) and of composite of heart failure, cardiogenic shock, and death (16.5% vs. 2.8%, p < 0.01). Conclusions Periprocedural bleeding was significantly associated with CI-AKI, with CI-AKI incidence correlating with bleeding severity.

Original languageEnglish
Pages (from-to)1260-1266
Number of pages7
JournalJournal of the American College of Cardiology
Volume62
Issue number14
DOIs
Publication statusPublished - 2013 Oct 1

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Percutaneous Coronary Intervention
Acute Kidney Injury
Hemorrhage
Incidence
Hemoglobins
Cardiogenic Shock
Contrast Media
Multicenter Studies
Registries
Creatinine
Japan
Heart Failure
Databases
Mortality
Serum

Keywords

  • bleeding
  • contrast-induced acute kidney injury

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Impact of periprocedural bleeding on incidence of contrast-induced acute kidney injury in patients treated with percutaneous coronary intervention. / Ohno, Yohei; Maekawa, Yuichiro; Miyata, Hiroaki; Inoue, Soushin; Ishikawa, Shiro; Sueyoshi, Koichiro; Noma, Shigetaka; Kawamura, Akio; Kosaka, Shun; Fukuda, Keiichi.

In: Journal of the American College of Cardiology, Vol. 62, No. 14, 01.10.2013, p. 1260-1266.

Research output: Contribution to journalArticle

Ohno, Yohei ; Maekawa, Yuichiro ; Miyata, Hiroaki ; Inoue, Soushin ; Ishikawa, Shiro ; Sueyoshi, Koichiro ; Noma, Shigetaka ; Kawamura, Akio ; Kosaka, Shun ; Fukuda, Keiichi. / Impact of periprocedural bleeding on incidence of contrast-induced acute kidney injury in patients treated with percutaneous coronary intervention. In: Journal of the American College of Cardiology. 2013 ; Vol. 62, No. 14. pp. 1260-1266.
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abstract = "Objectives This study sought to evaluate the association between contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention and severity of bleeding estimated from periprocedural hemoglobin (Hb) measurement. Background The relationship between CI-AKI and bleeding in contemporary practice remains controversial. Methods In a retrospective analysis of the prospectively maintained Japan Cardiovascular Database-Keio Interhospital Cardiovascular Studies (JCD-KICS) multicenter registry, we divided 2,646 consecutive patients into 5 groups according to the change of Hb level after compared with before percutaneous coronary intervention: Patients without a decrease in Hb level (group A) and patients with a decreased Hb level: <1 g/dl (group B); 1 to <2 g/dl (group C); 2 to <3g/dl (group D); and >3 g/dl (group E). CI-AKI was defined as an increase in serum creatinine level ≥0.5 mg/dl or ≥25{\%} above baseline values at 48 h after administration of contrast media. Procedure and outcome variables were compared. Results The mean patient age was 67 ± 11 years. Of the 2,646 patients, CI-AKI developed in 315 (11.9{\%}). The CI-AKI incidence was 6.2{\%}, 7.5{\%}, 10.7{\%}, 17.0{\%}, and 26.2{\%}, in groups A through E, respectively (p < 0.01), whereas the incidence of major bleeding was 0.7{\%}, 1.3{\%}, 2.0{\%}, 4.1{\%}, and 28.3{\%}, respectively (p < 0.01). CI-AKI was associated with higher rates of mortality (5.4{\%} vs. 0.6{\%}, p < 0.01) and of composite of heart failure, cardiogenic shock, and death (16.5{\%} vs. 2.8{\%}, p < 0.01). Conclusions Periprocedural bleeding was significantly associated with CI-AKI, with CI-AKI incidence correlating with bleeding severity.",
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T1 - Impact of periprocedural bleeding on incidence of contrast-induced acute kidney injury in patients treated with percutaneous coronary intervention

AU - Ohno, Yohei

AU - Maekawa, Yuichiro

AU - Miyata, Hiroaki

AU - Inoue, Soushin

AU - Ishikawa, Shiro

AU - Sueyoshi, Koichiro

AU - Noma, Shigetaka

AU - Kawamura, Akio

AU - Kosaka, Shun

AU - Fukuda, Keiichi

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Objectives This study sought to evaluate the association between contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention and severity of bleeding estimated from periprocedural hemoglobin (Hb) measurement. Background The relationship between CI-AKI and bleeding in contemporary practice remains controversial. Methods In a retrospective analysis of the prospectively maintained Japan Cardiovascular Database-Keio Interhospital Cardiovascular Studies (JCD-KICS) multicenter registry, we divided 2,646 consecutive patients into 5 groups according to the change of Hb level after compared with before percutaneous coronary intervention: Patients without a decrease in Hb level (group A) and patients with a decreased Hb level: <1 g/dl (group B); 1 to <2 g/dl (group C); 2 to <3g/dl (group D); and >3 g/dl (group E). CI-AKI was defined as an increase in serum creatinine level ≥0.5 mg/dl or ≥25% above baseline values at 48 h after administration of contrast media. Procedure and outcome variables were compared. Results The mean patient age was 67 ± 11 years. Of the 2,646 patients, CI-AKI developed in 315 (11.9%). The CI-AKI incidence was 6.2%, 7.5%, 10.7%, 17.0%, and 26.2%, in groups A through E, respectively (p < 0.01), whereas the incidence of major bleeding was 0.7%, 1.3%, 2.0%, 4.1%, and 28.3%, respectively (p < 0.01). CI-AKI was associated with higher rates of mortality (5.4% vs. 0.6%, p < 0.01) and of composite of heart failure, cardiogenic shock, and death (16.5% vs. 2.8%, p < 0.01). Conclusions Periprocedural bleeding was significantly associated with CI-AKI, with CI-AKI incidence correlating with bleeding severity.

AB - Objectives This study sought to evaluate the association between contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention and severity of bleeding estimated from periprocedural hemoglobin (Hb) measurement. Background The relationship between CI-AKI and bleeding in contemporary practice remains controversial. Methods In a retrospective analysis of the prospectively maintained Japan Cardiovascular Database-Keio Interhospital Cardiovascular Studies (JCD-KICS) multicenter registry, we divided 2,646 consecutive patients into 5 groups according to the change of Hb level after compared with before percutaneous coronary intervention: Patients without a decrease in Hb level (group A) and patients with a decreased Hb level: <1 g/dl (group B); 1 to <2 g/dl (group C); 2 to <3g/dl (group D); and >3 g/dl (group E). CI-AKI was defined as an increase in serum creatinine level ≥0.5 mg/dl or ≥25% above baseline values at 48 h after administration of contrast media. Procedure and outcome variables were compared. Results The mean patient age was 67 ± 11 years. Of the 2,646 patients, CI-AKI developed in 315 (11.9%). The CI-AKI incidence was 6.2%, 7.5%, 10.7%, 17.0%, and 26.2%, in groups A through E, respectively (p < 0.01), whereas the incidence of major bleeding was 0.7%, 1.3%, 2.0%, 4.1%, and 28.3%, respectively (p < 0.01). CI-AKI was associated with higher rates of mortality (5.4% vs. 0.6%, p < 0.01) and of composite of heart failure, cardiogenic shock, and death (16.5% vs. 2.8%, p < 0.01). Conclusions Periprocedural bleeding was significantly associated with CI-AKI, with CI-AKI incidence correlating with bleeding severity.

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KW - contrast-induced acute kidney injury

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