Author + information
- Luca Bertelli,
- Luigi Politi,
- Sara Roversi,
- Ylenia Bartolacelli,
- Salvatore perrone,
- Giuseppe Biondi Zoccai,
- Francesca Bursi,
- Giuseppe M. Sangiorgi and
- Maria Grazia Modena
Contrast–induced nephropathy (CIN) is a relatively frequent complication of percutaneous coronary and peripheral artery interventions and is associated with significant in–hospital and long term morbidity and mortality. We aim to compare the impact on major events of RenalGuard system (RG), continuous veno–venous Hemofiltration (CVVH) and hydration (Hy) with sodium bicarbonate plus N–acetylcysteine in patients with severe renal failure.
We assigned 100 consecutive not dialyzed patients with severe renal failure (eGFR ≤30 mL/min × 1.73m2 or with a baseline Serum Creatinine > 1.5 mg/dL, or with a CIN risk score ≥ 11) scheduled for an elective percutaneous coronary and/or peripheral interventions to a preventive strategy with RG (33 pts), CVVH (35 pts) or Hy (32 pts). Primary end points were In–Hospital and 1 month dialysis and MACEs, and CIN. Secondarily, 6–Month MACEs were recorded.
In–H dialysis occurred in none of RG patients, 7 (20%) of CVVH patients vs 2 (6.3%) of Hy group (p=0.013). In–H MACEs were significantly less frequent in RG procedure [RG:2 (6.1%), CVVH: 13 (37.1%) and Hy: 4 (12,5%) p=0.003; OR RG vs CVVH: 0.12; CI:0.02–0.60, p=0.01]. Similar trends were seen at 1 and 6 month follow–up. In particular, none of RG patients died at 6 month FU, vs 9 (25,7%) CVVH patients and 2 (6,3%) Hydration protocol patients (p=0.002). Albeit not significant, CIN occurred less frequently in RG patients (15.2%) than CVVH (31.4%) and hydration protocol (25.0%) (p=0,288).
For the first time, RenalGuard(r) system, CVVH and hydration with sodium bicarbonate and N–Acetylcysteine were compared in a real–world population: RG demonstrated to be a safe procedure and to significantly reduce the risk of In–Hospital, 1 month and 6 month MACEs, compared to continuous veno–venous Hemofiltration and Hydration.
i2 Poster Contributions
McCormick Place South, Hall A
Saturday, March 24, 2012, 9:30 a.m.–Noon
Session Title: PCI in Complex Patients
Abstract Category: 4. Outcomes/Operator Volume/Public Reporting/Misc. Topics/Guidelines
Presentation number: 2525–377
- 2012 American College of Cardiology Foundation