Prophylaxis of contrast-induced nephropathy in high risk patients with non-ST-segment elevation acute coronary syndrome

Authors

  • Pablo Revilla Martí Hospital Clínico Universitario "Lozano Blesa"
  • José A. Linares Vicente Hospital Clínico Universitario "Lozano Blesa"
  • Pilar Artero Bello Hospital Clínico Universitario "Lozano Blesa"
  • Ramón Bascompte Claret Hospital Clínico Universitario "Lozano Blesa"
  • Tatiana Matajira Chia Hospital Clínico Universitario "Lozano Blesa"
  • Pilar Portero Pérez Hospital Clínico Universitario "Lozano Blesa"
  • José R. Ruiz Arroyo Hospital Clínico Universitario "Lozano Blesa"

Keywords:

coronary intervention, iodine contrast medium, contrast-induced nephropathy

Abstract

Introduction and Objectives: The effectiveness of the administration of isotonic saline solution and N-acetylcysteine shows different results in the prevention of iodine contrast nephropathy. Our objective was to assess the potential effectiveness of this combined strategy in patients at high risk for contrast-induced nephropathy, who were admitted in our center for percutaneous coronary intervention due to non-ST-segment elevation acute coronary syndrome. Method: This strategy was applied in the patients mentioned, with at least one risk factor for developing contrast-induced nephropathy: over 80 years, diabetes mellitus, baseline creatinine greater than 1.5 mg / dl or high volume of contrast (greater than 400 ml). The protocol was applied for 12 months (patients that received the prevention protocol) and compared with similar patients in the previous 12 months who received no prophylaxis. Results: A total of 30 patients (24 %) developed contrast-induced nephropathy. The percentage was significantly higher in the group that did not receive prophylaxis: 35.9 % vs. 11.5 % (p = 0.003). Conclusions: The combination of N-acetylcysteine orally and parenteral hydration in high-risk patients with acute coronary syndrome without ST elevation could be beneficial to avoid the appearance of contrast-induced nephropathy.

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References

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Published

2012-09-16

How to Cite

1.
Revilla Martí P, Linares Vicente JA, Artero Bello P, Bascompte Claret R, Matajira Chia T, Portero Pérez P, et al. Prophylaxis of contrast-induced nephropathy in high risk patients with non-ST-segment elevation acute coronary syndrome. CorSalud [Internet]. 2012 Sep. 16 [cited 2025 Oct. 2];4(3):151-6. Available from: https://revcorsalud.sld.cu/index.php/cors/article/view/1222