Studies on the differences of major adverse cardio- And cerebrovascular events and the acute renal injury caused by contrast agents in Chinese patients of different ages receiving iodoxadol for PCI / 解放军医学杂志

ABSTRACT

Objective To explore the differences of the main adverse cardio- and cerebrovascular events (MACCE) and contrast-induced acute kidney injury (CIAKI) in Chinese patients of different ages who receiving percutaneous coronary intervention (PCI) therapy with iodoxanol. Methods A total of 3042 patients from 30 centers in China were enrolled in present IMPERIAL study (China clinical trial register ChiCTR-ONC-13003733) from Oct. 30, 2013 to Oct. 7, 2015. Enrolled patients were observed for 3 days during hospitalization, and followed-up for one month after discharge. All the enrolled patients were divided into three groups according to their age patients in group A aged less than 65 years (n=1748), in group B aged 65-75 years (n=828), and in group C were elder than 75 years (n=466). The primary end point was the incidence of MACCE (composite outcomes events of revascularization of target lesions, stroke, stent thrombosis, cardiac death and nonfatal myocardial infarction) and CIAKI in hospital 72 h after PCI. The secondary end point was the incidence of MACCE 72 h-30 d after PCI. Results Primary end point events among the three groups were shown as below There was no statistical significance in revascularization of target lesions, stroke, stent thrombosis, cardiac death and nonfatal myocardial infarction (P>0.05). The incidence of CIAKI in group A, group B and group C [7.1% (121/1702), 7.8% (63/806), and 10.7%(49/458), respectively] showed statistical difference (P=0.016). And the incidence of cardiac death was 0% (0/1748) in group A, 0.12% (1/828) in group B, and 0.43% (2/466) in group C, showed significant difference (P=0.031). While the incidence showed no statistical significance (P>0.05) of revascularization of target lesions, stroke, stent thrombosis, and nonfatal myocardial infarction among the three groups. Conclusions Iodioxadol is safe and feasible for coronary intervention in Chinese patients of different ages, only CIAKI and the incidence of cardiogenic death after discharge increased with age.