Author + information
- Thejasvi Thiruvoipati,
- Fredy El Sakr,
- Scott Grey,
- Hitinder Gurm and
- Paul Grossman
Background: Contrast induced nephropathy (CIN), defined as an increase in serum creatinine (sCr) from baseline to post intervention peak of at least 0.5 mg/dL, occurs in about 4% of patients undergoing peripheral vascular interventions and is associated with adverse outcomes. Hydration status is a modifiable risk factor for the incidence of CIN post percutaneous coronary intervention. However, the utility and the timing of peri-procedural hydration intended to reduce the incidence of CIN post PVI is unknown.
Methods: Using the BMC2 Peripheral Vascular Intervention (PVI) database, we identified 29 hospitals from 2014 where post-PVI peak sCr was measured in at least 55% of patients. Hydration protocols were at the discretion of hospitals and not pre-specified. The relationship between pre and post PVI hydration rates and their impact on CIN rates was examined with scatterplots, correlation and regression.
Results: The site level rates of pre-hydration varied from 7% to 99%. Incidence of CIN ranged from 2% to 8% and was inversely correlated with institutional rate of pre-hydration (p < 0.01). Sites with high rates of pre-hydration were found to have higher rates of post-hydration (p < 0.001). CIN rates were nominally lower in sites implementing both pre and post-hydration, compared to pre-hydration alone (p= 0.33).
Conclusions: Institutional level rates of pre-hydration are associated with lower rates of CIN post PVI. An even lower incidence of CIN is observed in sites with high rates of pre and post-hydration.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Complexity and Complications
Abstract Category: 18. Interventional Cardiology: Carotid and Endovascular Intervention
Presentation Number: 1285-163
- 2017 American College of Cardiology Foundation