What factors are Associated with the Development of Contras-induced Nephropathy in Elderly Patients with Acute Coronary Syndrome in Real Clinical Practice?

Aim. To study the factors associated with contrast-induced acute kidney injury in elderly patients with acute coronary syndrome (ACS).Material and Methods. A retrospective analysis of 514 electronic medical records of patients aged 75 years and over (38% men and 62% women) with confirmed acute coron...

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Main Authors: M. Yu. Gilyarov, E. V. Konstantinova, P. V. Kovalets, A. V. Slivin, A. E. Udovichenko, A. P. Nesterov, O. N. Svetlova, A. V. Svet
Format: Article
Language:English
Published: Столичная издательская компания 2020-12-01
Series:Рациональная фармакотерапия в кардиологии
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Online Access:https://www.rpcardio.online/jour/article/view/2345
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author M. Yu. Gilyarov
E. V. Konstantinova
P. V. Kovalets
A. V. Slivin
A. E. Udovichenko
A. P. Nesterov
O. N. Svetlova
A. V. Svet
author_facet M. Yu. Gilyarov
E. V. Konstantinova
P. V. Kovalets
A. V. Slivin
A. E. Udovichenko
A. P. Nesterov
O. N. Svetlova
A. V. Svet
author_sort M. Yu. Gilyarov
collection DOAJ
description Aim. To study the factors associated with contrast-induced acute kidney injury in elderly patients with acute coronary syndrome (ACS).Material and Methods. A retrospective analysis of 514 electronic medical records of patients aged 75 years and over (38% men and 62% women) with confirmed acute coronary syndrome has been performed. The contrast-induced acute kidney injury was defined as an increase in serum creatinine ≥26.5 μmol/L in 48 h or as an increase in serum creatinine in 1.5 times within 7 days after the contrast media exposure. Patients were divided into contrast-induced acute kidney injury and non-contrast-induced acute kidney injury group. Clinical characteristics and in-hospital outcomes were extracted from patients' medical records. Procedural characteristics were obtained from laboratory database.Results. Angiographic intervention was performed in 74% of patients, 32% of them (more often in women, p=0.033) were diagnosed with contrast-induced acute kidney injury. Patients with contrast-induced acute kidney injury are characterized by a higher death rate (17% и 3%, p<0.001) and were more likely to have heart failure with reduced ejection fraction (34% и 21%, p=0.008) and acute heart failure (Killip class II-IV) (24% и 16%, p=0.015). The risk of developing contrast-induced acute kidney injury was related the volume of contrast medium administered.Conclusions. Prevention particular care should be taken to female patients older than 75 years with ACS, with a history of the chronic heart failure with reduced ejection fraction or acute heart failure (Killip class II-IV), and with a high volume of contrast media, highlighting that a perioperative comprehensive management strategy is needed to improve the prognosis.
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spelling doaj-art-a45a7fc9e46846dcae7a35a687659c8d2025-08-23T10:00:33ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532020-12-0116690891510.20996/1819-6446-2020-12-021816What factors are Associated with the Development of Contras-induced Nephropathy in Elderly Patients with Acute Coronary Syndrome in Real Clinical Practice?M. Yu. Gilyarov0E. V. Konstantinova1P. V. Kovalets2A. V. Slivin3A. E. Udovichenko4A. P. Nesterov5O. N. Svetlova6A. V. Svet7City Clinical Hospital №1 n.a. N.I. Pirogov; Pirogov Russian National Research Medical University; I.M. Sechenov First Moscow State Medical University (Sechenov University)City Clinical Hospital №1 n.a. N.I. Pirogov; Pirogov Russian National Research Medical UniversityPirogov Russian National Research Medical UniversityPirogov Russian National Research Medical UniversityCity Clinical Hospital №1 n.a. N.I. Pirogov; Pirogov Russian National Research Medical University; I.M. Sechenov First Moscow State Medical University (Sechenov University)City Clinical Hospital №1 n.a. N.I. Pirogov; Pirogov Russian National Research Medical UniversityCity Clinical Hospital №1 n.a. N.I. PirogovCity Clinical Hospital №1 n.a. N.I. Pirogov; I.M. Sechenov First Moscow State Medical University (Sechenov University)Aim. To study the factors associated with contrast-induced acute kidney injury in elderly patients with acute coronary syndrome (ACS).Material and Methods. A retrospective analysis of 514 electronic medical records of patients aged 75 years and over (38% men and 62% women) with confirmed acute coronary syndrome has been performed. The contrast-induced acute kidney injury was defined as an increase in serum creatinine ≥26.5 μmol/L in 48 h or as an increase in serum creatinine in 1.5 times within 7 days after the contrast media exposure. Patients were divided into contrast-induced acute kidney injury and non-contrast-induced acute kidney injury group. Clinical characteristics and in-hospital outcomes were extracted from patients' medical records. Procedural characteristics were obtained from laboratory database.Results. Angiographic intervention was performed in 74% of patients, 32% of them (more often in women, p=0.033) were diagnosed with contrast-induced acute kidney injury. Patients with contrast-induced acute kidney injury are characterized by a higher death rate (17% и 3%, p<0.001) and were more likely to have heart failure with reduced ejection fraction (34% и 21%, p=0.008) and acute heart failure (Killip class II-IV) (24% и 16%, p=0.015). The risk of developing contrast-induced acute kidney injury was related the volume of contrast medium administered.Conclusions. Prevention particular care should be taken to female patients older than 75 years with ACS, with a history of the chronic heart failure with reduced ejection fraction or acute heart failure (Killip class II-IV), and with a high volume of contrast media, highlighting that a perioperative comprehensive management strategy is needed to improve the prognosis.https://www.rpcardio.online/jour/article/view/2345contrast-induced acute kidney injuryacute coronary syndromeelderly patientsrisk factorsdeath rate
spellingShingle M. Yu. Gilyarov
E. V. Konstantinova
P. V. Kovalets
A. V. Slivin
A. E. Udovichenko
A. P. Nesterov
O. N. Svetlova
A. V. Svet
What factors are Associated with the Development of Contras-induced Nephropathy in Elderly Patients with Acute Coronary Syndrome in Real Clinical Practice?
Рациональная фармакотерапия в кардиологии
contrast-induced acute kidney injury
acute coronary syndrome
elderly patients
risk factors
death rate
title What factors are Associated with the Development of Contras-induced Nephropathy in Elderly Patients with Acute Coronary Syndrome in Real Clinical Practice?
title_full What factors are Associated with the Development of Contras-induced Nephropathy in Elderly Patients with Acute Coronary Syndrome in Real Clinical Practice?
title_fullStr What factors are Associated with the Development of Contras-induced Nephropathy in Elderly Patients with Acute Coronary Syndrome in Real Clinical Practice?
title_full_unstemmed What factors are Associated with the Development of Contras-induced Nephropathy in Elderly Patients with Acute Coronary Syndrome in Real Clinical Practice?
title_short What factors are Associated with the Development of Contras-induced Nephropathy in Elderly Patients with Acute Coronary Syndrome in Real Clinical Practice?
title_sort what factors are associated with the development of contras induced nephropathy in elderly patients with acute coronary syndrome in real clinical practice
topic contrast-induced acute kidney injury
acute coronary syndrome
elderly patients
risk factors
death rate
url https://www.rpcardio.online/jour/article/view/2345
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