Effect and safety of rosuvastatin for prevention of contrast-induced acute kidney injury after percutaneous coronary intervention in patients with diabetes associated with mild-moderate renal insufficiency / 解放军医学杂志

ABSTRACT

Objective To explore the safety and efficacy of rosuvastatin on development of contrast-induced acute kidney injury (CIAKI) due to application of diuretic furosemide after coronary or peripheral vascular intervention during perioperative period in patients with diabetes mellitus (DM) associated with mild-moderate renal insufficiency (MMRI). Methods From Dec. 2008 to Oct. 2011, 2998 patients from 53 centers in China were enrolled in a TRACK-D project. Of them 650 patients with type 2 DM and concomitant MMRI, who received furosemide, were divided into rosuvastatin group (n=321) and control group (n=329), and all underwent coronary/peripheral arterial diagnostic angiography or left heart ventricular angiography. Patients in rosuvastatin group were treated by percutaneous intervention with rosuvastatin 10mg/d every evening for five days (two days before and three days after operation), while those in control group did not receive any statins before operation and within 72 hours after operation. Serum creatinine (Scr) was measured 48 hours before and 48 and 72 hours after exposure to contrast medium, and the incidence of CIAKI was simultaneously observed. Clinical follow-up of cardiovascular events was done at the 30th day after treatment, including heart function aggravation, all-cause mortality, renal dysfunction-induced dialysis and hemofiltration, etc. Results Baseline data were similar between the two groups. Patients randomized to the rosuvastatin group had a significantly lower incidence of CIAKI compared with controls (5.0% vs 9.7%, P=0.024). Clinical follow-up done at the 30th day after treatment indicated that there was no statistical difference in incidence of dialysis, hemofiltration and all-cause mortality between rosuvastatin group and control group. Conclusions Rosuvastatin may significantly reduce the risk of CIAKI in patients with DM associated with MMRI and receive the furosemide during the perioperative period.