Race, contrast-induced nephropathy and long-term outcomes after coronary and peripheral angiography and intervention

Cardiovasc Revasc Med. 2018 Sep;19(6S):31-35. doi: 10.1016/j.carrev.2018.06.016. Epub 2018 Jun 25.

Abstract

Background: Contrast-induced nephropathy (CIN) is a complication of diagnostic angiography and percutaneous coronary and endovascular intervention. We investigated the effect of race on the development of CIN.

Methods: We studied 4070 predominantly male patients undergoing peripheral and coronary angiography and percutaneous coronary and endovascular intervention. We analyzed the incidence of CIN at 72 h, of renal dysfunction at 3 months as well as the long-term incidence of hemodialysis and of death.

Results: The mean age was 67.2 years. CIN occurred in 92 (7.1%) Caucasian patients and in 42 (6.6%) non-Caucasians at 72 h after the procedure (odds ratio [OR] 1.08, 95% confidence interval [CI] 0.74-1.57; P = 0.69). At 3 months, renal dysfunction was seen in 231 (11.24%) Caucasian patients versus 121 (11.52%) of the non-Caucasian group (OR 0.97, CI 0.77-1.23; P = 0.81). After a follow-up of 5 years, of the 4070 patients, 17 patients (0.64%) of the Caucasian group were placed on dialysis versus 27 (1.88%) of the non-Caucasian group (OR 0.34, 0.18-0.62; P = 0.0004) and 535 (20.28%) of the Caucasian patients had died compared to 293 (20.44%) of the non-Caucasian group (OR = 0.99, 95% CI 0.85-1.17; P = 0.94).

Conclusions: In this cohort of patients, race was not associated with the development of CIN at 72 h, or the development of renal dysfunction at 3 months post angiography or intervention. In the long-term, the rate of initiation of dialysis was significantly lower in the Caucasian patients but mortality was not.

MeSH terms

  • Aged
  • Angiography / adverse effects*
  • Black or African American
  • Contrast Media / adverse effects*
  • Coronary Angiography / adverse effects
  • Endovascular Procedures / adverse effects*
  • Female
  • Hispanic or Latino
  • Humans
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / ethnology*
  • Kidney Diseases / mortality
  • Kidney Diseases / therapy
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / adverse effects*
  • Renal Dialysis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Veterans Health / ethnology
  • Virginia / epidemiology
  • White People*

Substances

  • Contrast Media