Akademik Veri Yönetim Sistemi
EuroPCR 2020, Paris, Fransa, 25 - 27 Haziran 2020, ss.355, (Özet Bildiri)
Aims: Routine hydration therapy investigation studies frequently included patients with stable coronary artery disease and with a high risk
of CI-AKI (GFR <60ml / min). However, data on routine hydration treatment in non–ST-segment elevation myocardial infarction (NSTEMI)
patients with GFR ≥ 60ml / min are insufficient. In our study, we aimed to investigate the relationship between routine hydration therapy
and CI-AKI development in patients with NSTEMI and low risk for nephropathy.
Methods and results: NSTEMI patients who has undergone coronary angiography were enrolled study. Randomisation was performed in
a 1:1 ratio with computer-generated random numbers. 462 patients with NSTEMI that 31 patients had GFR<60 ml/min, 22 had EF less than
30%, 5 had a Killip score of 3-4, 3 had cardiac arrest who were excluded from the study. Thus, 401 patients were included study, 203 patients
in the non-hydration group and 198 patients in the hydration group. Intravenous hydration with isotonic saline (1 ml/kg/h, 0.9% sodium
chloride) was given for 3-12 hours before, and 24 hours after, contrast exposure to the hydration group. CI-AKI is defined as the increase
in serum creatinine values 0.5 ml/min or 25% at the 48-72th hour after CAG compared to baseline. Results: In our study, the incidence of
CI-AKI development in the routine hydration group (7.1%) was significantly lower than the non-hydration group (14.1%) (p=0.02). The
MEHRAN risk score was found to be ≤ 5 in 77.6% of the patients participated in the study. In addition, the MEHRAN risk score was
significantly higher in the routine hydration group (mean 4) than in the non-hydration group (mean 3) (p<0.01). The median age (63 years)
was significantly higher in the routine hydration group than the non-hydration group (58 years) (p<0.01). The predictors of CI-AKI in the
univariate analysis were older age (68.5 vs 60.1 years; p<0.01), lower haemoglobin level before the procedure (13.2 vs 13.5 g/dl; p: 0.03)
and no hydration therapy (32.6% vs 51.4%; p<0.02). This study revealed that older age (OR: 1.06, CI 95% [1.03-1.10], p<0.01), amount of
contrast media (OR: 1.01, CI 95% [1.00-1.02], p: 0.04) and routine hydration (OR: 0.30, CI 95% [0.14-0.63], p<0.01) were independent
risk factors for developing CI-AKI.
Conclusions: Routine hydration therapy mitigates the development of CI-AKI in patients with NSTEMI who are at low risk for nephropathy.
Advanced age and large amount of contrast media usage increase development of CI-AKI, while the incidence of CI-AKI decreases in
patients receiving routine hydration therapy. Routine use of hydration therapy in patients with NSTEMI may reduce mortality and morbidity
associated with CI-AKI that further studies are needed.