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Short-term Rosuvastatin Treatment for the Prevention of Contrast-induced Acute Kidney Injury in Patients Receiving Moderate or High Volumes of Contrast Media: A Sub-analysis of the TRACK-D Study

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文摘 Background: Current randomized trials have demonstrated the effects of short-term rosuvastatin therapy in preventing contrast-induced acute kidney injury (CIAKI). However, the consistency of these effects on patients administered different volumes of contrast media is unknown. Methods: In the TRACK-D trial, 2998 patients with type 2 diabetes and concomitant chronic kidney disease (CKD) who underwent coronary/peripheral arterial angiography with or without percutaneous intervention were randomized to short-term (2 days before and 3 days after procedure) rosuvastatin therapy or standard-of-care. This prespecified analysis compared the effects of rosuvastatin versus standard therapy in patients exposed to (moderate contrast volume [MCV], 200-300 ml, n = 712) or (high contrast volume [HCV], ≥300 ml, n = 220). The primary outcome was the incidence of CIAKI. The secondary outcome was a composite of death, dialysis/hemofiltration or worsened heart failure at 30 days. Results: Rosuvastatin treatment was associated with a significant reduction in CIAKI compared with the controls (2.1% vs. 4.4%, P= 0.050) in the overall cohort and in patients with MCV (1.7% vs. 4.5%, P= 0.029), whereas no benefit was observed in patients with HCV (3.4% vs. 3.9%, P = 0.834). The incidence of secondary outcomes was significantly lower in the rosuvastatin group compared with control group (2.7% vs. 5.3%, P = 0.049) in the overall cohort, but it was similar between the patients with MCV (2.0% vs. 4.2%, P = 0.081) or HCV (5.1 % vs. 8.8%, P = 0.273). Conclusions: Periprocedural short-term rosuvastatin treatment is effective in reducing CIAKI and adverse clinical events for patients with diabetes and CKD after their exposure to a moderate volume of contrast medium.
来源 Chinese Medical Journal ,2015,128(6):784-789 【核心库】
DOI 10.4103/0366-6999.152620
关键词 Chronic Kidney Disease ; Contrast-induced Acute Kidney Injury ; Rosuvastatin
地址

1. Department of Cardiology, General Hospital of Shenyang Military Region, Liaoning, Shenyang, 110840  

2. Department of Cardiology, First Hospital of Liaoning Medical College, Liaoning, Jinzhou, 110840  

3. Department of Cardiology, General Hospital of People's Liberation Army, Beijing, 100853  

4. Department of Cardiology, The Second Artillery General Hospital of People's Liberation Army, Beijing, 100088  

5. Department of Cardiology, No. 252 Hospital of People's Liberation Army, Hebei, Baoding, 071000

语种 英文
文献类型 研究性论文
ISSN 0366-6999
学科 临床医学
基金 Key Project of National 12~(th) Five-Year Research Program of China ;  supported by grants from the Key Technologies R and D Project of Liaoning Province
文献收藏号 CSCD:5363389

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