Ultra-low CONtraSt PCI vs conVEntional PCI in patients of ACS with increased risk of CI-AKI (CONSaVE-AKI)
Objectives: This prospective, randomized study assessed short-term outcomes and safety of ultra-low contrast percutaneous coronary intervention(ULC-PCI) vs conventional PCI in high risk for contrast induced acute kidney injury(CI-AKI) patients presenting with acute coronary syndrome(ACS). Background...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-09-01
|
| Series: | Indian Heart Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483222001286 |
| _version_ | 1828156280097734656 |
|---|---|
| author | Abhinav Shrivastava Ranjit Kumar Nath Himansu Sekhar Mahapatra Bhagya Narayan Pandit Ajay Raj Ajay Kumar Sharma Tarun Kumar Dheerendra Kuber Puneet Aggarwal |
| author_facet | Abhinav Shrivastava Ranjit Kumar Nath Himansu Sekhar Mahapatra Bhagya Narayan Pandit Ajay Raj Ajay Kumar Sharma Tarun Kumar Dheerendra Kuber Puneet Aggarwal |
| author_sort | Abhinav Shrivastava |
| collection | DOAJ |
| description | Objectives: This prospective, randomized study assessed short-term outcomes and safety of ultra-low contrast percutaneous coronary intervention(ULC-PCI) vs conventional PCI in high risk for contrast induced acute kidney injury(CI-AKI) patients presenting with acute coronary syndrome(ACS). Background: Patients at an increased risk of developing CI-AKI can be identified prior to PCI based on their pre-procedural risk scores. ULC-PCI is a novel contrast conservation strategy in such high risk patients for prevention of CI-AKI. Methods: 82 patients undergoing PCI for ACS were enrolled having estimated glomerular filtration rate(eGFR) < 60 ml/min/1.73 m2 and moderate to very high pre-procedural risk of developing CI-AKI as calculated by Maioli risk calculator. They were randomized into two groups of 41 patients each of ULC-PCI (contrast volume ≤ patient's eGFR) and conventional PCI (contrast volume ≤ 3xpatient's eGFR). Primary end point was development of CI-AKI. Results: Baseline clinical and angiographic characteristics were similar between groups. Primary outcome of CI-AKI occurred more in patients of the conventional PCI group [7 (17.1%)] than in the ULC PCI group [(0 patients), p = 0.012]. Contrast volume (41.02 (±9.8) ml vs 112.54 (±25.18) ml; P < 0.0001) was markedly lower in the ULC-PCI group. No significant difference in secondary safety outcomes between two study arms at 30 days. IVUS was used in 17% patients in ULC PCI. Conclusion: ULC-PCI in patients with increased risk of developing CI-AKI is feasible, appears safe, and has the potential to decrease the incidence of CI-AKI specially in resource limited setting such as ours where coronary imaging by IVUS is not possible in every patient. |
| first_indexed | 2024-04-11T23:09:20Z |
| format | Article |
| id | doaj.art-fd9e7182880b471f9bf65a2ecb0238a1 |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-04-11T23:09:20Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-fd9e7182880b471f9bf65a2ecb0238a12022-12-22T03:57:55ZengElsevierIndian Heart Journal0019-48322022-09-01745363368Ultra-low CONtraSt PCI vs conVEntional PCI in patients of ACS with increased risk of CI-AKI (CONSaVE-AKI)Abhinav Shrivastava0Ranjit Kumar Nath1Himansu Sekhar Mahapatra2Bhagya Narayan Pandit3Ajay Raj4Ajay Kumar Sharma5Tarun Kumar6Dheerendra Kuber7Puneet Aggarwal8Department of Cardiology, ABVIMS, Dr R.M.L. Hospital, New Delhi, India; Corresponding author. 32/31, West Patel Nagar, New Delhi, 110008, India.Department of Cardiology, ABVIMS, Dr R.M.L. Hospital, New Delhi, IndiaDepartment of Nephrology, ABVIMS, Dr R.M.L. Hospital, New Delhi, IndiaDepartment of Cardiology, ABVIMS, Dr R.M.L. Hospital, New Delhi, IndiaDepartment of Cardiology, ABVIMS, Dr R.M.L. Hospital, New Delhi, IndiaDepartment of Cardiology, ABVIMS, Dr R.M.L. Hospital, New Delhi, IndiaDepartment of Cardiology, ABVIMS, Dr R.M.L. Hospital, New Delhi, IndiaDepartment of Cardiology, ABVIMS, Dr R.M.L. Hospital, New Delhi, IndiaDepartment of Cardiology, ABVIMS, Dr R.M.L. Hospital, New Delhi, IndiaObjectives: This prospective, randomized study assessed short-term outcomes and safety of ultra-low contrast percutaneous coronary intervention(ULC-PCI) vs conventional PCI in high risk for contrast induced acute kidney injury(CI-AKI) patients presenting with acute coronary syndrome(ACS). Background: Patients at an increased risk of developing CI-AKI can be identified prior to PCI based on their pre-procedural risk scores. ULC-PCI is a novel contrast conservation strategy in such high risk patients for prevention of CI-AKI. Methods: 82 patients undergoing PCI for ACS were enrolled having estimated glomerular filtration rate(eGFR) < 60 ml/min/1.73 m2 and moderate to very high pre-procedural risk of developing CI-AKI as calculated by Maioli risk calculator. They were randomized into two groups of 41 patients each of ULC-PCI (contrast volume ≤ patient's eGFR) and conventional PCI (contrast volume ≤ 3xpatient's eGFR). Primary end point was development of CI-AKI. Results: Baseline clinical and angiographic characteristics were similar between groups. Primary outcome of CI-AKI occurred more in patients of the conventional PCI group [7 (17.1%)] than in the ULC PCI group [(0 patients), p = 0.012]. Contrast volume (41.02 (±9.8) ml vs 112.54 (±25.18) ml; P < 0.0001) was markedly lower in the ULC-PCI group. No significant difference in secondary safety outcomes between two study arms at 30 days. IVUS was used in 17% patients in ULC PCI. Conclusion: ULC-PCI in patients with increased risk of developing CI-AKI is feasible, appears safe, and has the potential to decrease the incidence of CI-AKI specially in resource limited setting such as ours where coronary imaging by IVUS is not possible in every patient.http://www.sciencedirect.com/science/article/pii/S0019483222001286Percutaneous coronary interventionUltra-low contrast PCIIVUSContrast induced acute kidney injuryContrast induced nephropathyAcute coronary syndrome |
| spellingShingle | Abhinav Shrivastava Ranjit Kumar Nath Himansu Sekhar Mahapatra Bhagya Narayan Pandit Ajay Raj Ajay Kumar Sharma Tarun Kumar Dheerendra Kuber Puneet Aggarwal Ultra-low CONtraSt PCI vs conVEntional PCI in patients of ACS with increased risk of CI-AKI (CONSaVE-AKI) Indian Heart Journal Percutaneous coronary intervention Ultra-low contrast PCI IVUS Contrast induced acute kidney injury Contrast induced nephropathy Acute coronary syndrome |
| title | Ultra-low CONtraSt PCI vs conVEntional PCI in patients of ACS with increased risk of CI-AKI (CONSaVE-AKI) |
| title_full | Ultra-low CONtraSt PCI vs conVEntional PCI in patients of ACS with increased risk of CI-AKI (CONSaVE-AKI) |
| title_fullStr | Ultra-low CONtraSt PCI vs conVEntional PCI in patients of ACS with increased risk of CI-AKI (CONSaVE-AKI) |
| title_full_unstemmed | Ultra-low CONtraSt PCI vs conVEntional PCI in patients of ACS with increased risk of CI-AKI (CONSaVE-AKI) |
| title_short | Ultra-low CONtraSt PCI vs conVEntional PCI in patients of ACS with increased risk of CI-AKI (CONSaVE-AKI) |
| title_sort | ultra low contrast pci vs conventional pci in patients of acs with increased risk of ci aki consave aki |
| topic | Percutaneous coronary intervention Ultra-low contrast PCI IVUS Contrast induced acute kidney injury Contrast induced nephropathy Acute coronary syndrome |
| url | http://www.sciencedirect.com/science/article/pii/S0019483222001286 |
| work_keys_str_mv | AT abhinavshrivastava ultralowcontrastpcivsconventionalpciinpatientsofacswithincreasedriskofciakiconsaveaki AT ranjitkumarnath ultralowcontrastpcivsconventionalpciinpatientsofacswithincreasedriskofciakiconsaveaki AT himansusekharmahapatra ultralowcontrastpcivsconventionalpciinpatientsofacswithincreasedriskofciakiconsaveaki AT bhagyanarayanpandit ultralowcontrastpcivsconventionalpciinpatientsofacswithincreasedriskofciakiconsaveaki AT ajayraj ultralowcontrastpcivsconventionalpciinpatientsofacswithincreasedriskofciakiconsaveaki AT ajaykumarsharma ultralowcontrastpcivsconventionalpciinpatientsofacswithincreasedriskofciakiconsaveaki AT tarunkumar ultralowcontrastpcivsconventionalpciinpatientsofacswithincreasedriskofciakiconsaveaki AT dheerendrakuber ultralowcontrastpcivsconventionalpciinpatientsofacswithincreasedriskofciakiconsaveaki AT puneetaggarwal ultralowcontrastpcivsconventionalpciinpatientsofacswithincreasedriskofciakiconsaveaki |