Influence of iso-osmolar contrast media on renal function in patients with chronic heart failure ;undergoing coronary interventional therapy / 中国医师进修杂志

ABSTRACT

Objective To compare iso-osmolar iodixanol and low-osmolar iohexol for the incidence of contrast- induced nephropathy(CIN) in patients with chronic congestive heart failure undergoing coronary interventional therapy. Methods The study included 220 consecutive patients with chronic congestive heart failure and undergoing coronary angiography (CAG) with or without percutaneous coronary intervention (PCI) bewteen Janurary 2015 and May 2016. Study participants were divided into two groups by random digits tableiso-osmolar group (110 patients) and low-osmolar group (110 patients). The patients in iso-osmolar group were given iodixanol, and the patients in low-osmolar group were given iohexol. Serum creatinine (SCr), glomerular filtration rate (GFR) and cystatin C (CysC) were detected before the procedure and on the first, third day after the procedure. Then, the incidence of contrast-induced nephropathy (CIN) in two groups within 72 h of the procedure were observed and compared. Results The levels of SCr, GFR, CysC before operation had no significant differences (P>0.05). The levels of SCr in two groups on the first day after operation were increased, but there was no significant difference between two groups (P>0.05). On the first day after operation, the level of GFR in iso-osmolar group was higher than that in low-osmolar group, the level of CysC in iso-osmolar group was lower than that in low-osmolar group, and there were significant differences (P<0.05). On the third day after operation, the level of GFR in iso-osmolar group was higher than that in low-osmolar group, the level of CysC in iso-osmolar group was lower than that in low-osmolar group, and there were significant differences (P<0.01). The overall incidence of CIN was 20.9%(46/220). The incidence of CIN in low-osmolar group was 29.1%(32/110), in iso-osmolar group was 12.7%(14/110), and there was significant difference (P<0.05). Conclusions In chronic congestive heart failure patients undergoing coronary interventional therapy, the iso-osmolar contrast iodixanol is associated with a lower incidence of CIN compared with low-osmolar iohexol.