The Relationship Between The Dose Of Contrast Agent With The Change Of Serum Creatinine And EGFR Levels And Short-Medium-term Adverse Events In Patients Receiving PCI

Objective：The aim of the study was to contrast the changes of serum creatinineand eGFR between different contrast dose groups before and after PCI and record theincidence of short-medium-term adverse events, and to evaluate the correlation betweenthe above-mentioned factors. The influence of different contrast dose on the severityof renal function injury during PCI and the relationship between the dose of contrastagent during the PCI with short-medium-term adverse events was also investigated.Methods：the clinical data of462patients receiving PCI at the First AffiliatedHospital of Dalian Medical University was collected retrospectively from July2009toJune2010. according to the dose of contrast agent, all the patients were divided intotwo groups, that is, dose of <150mL group(n=103) and dose of≥150mL group(n=359).To record the Scr, eGFR and Ccr before and1week,1month,3months and9monthsafter PCI of these patients. At the same time, the occurrence of short-medium-termadverse cardiovascular events of the two groups of patients, such as re-infarction,re-PCI, coronary artery bypass and sudden death was recorded.Results：Clinical baseline characteristics of the two groups of patients had nostatistical significant difference（p>0.05）. There were no statistically significantdifferences between the two groups of patients’ Scr and eGFR before the PCI, Scr andeGFR of1week,1month,3months,9months after the PCI and Ccr of1month,3months,9months after the PCI（p>0.05）. the incidence of CIN of the two groups werecompared, results showed that dose of <150mL group was4.9%, dose of≥150mL groupwas5.3%, there was no significant diffierence between the two groups（p>0.05）.Analysis results of the incidence of short-medium-term cardiovascularadverse events, showed that there were13cases (12.61%) in the dose of <150mL group and41cases (11.42%) in the dose≥150mL group. The data of the two groups had nosignificant difference（p>0.05）. There was significant difference(p<0.0001) between theScr before and1week after PCI,they were76.16±28.11and81.73±37.08, respectively.There was no significant difference(p=0.814)between the Scr before and1month afterPCI, they were76.16±28.11and76.55±33.37, respectively.There was also nosignificant difference(p=0.088)between the Scr before and3months after PCI, theywere76.16±28.11and73.56±29.81, respectively. There was significant difference（p<0.001）between the Scr befor and9months after PCI, they were76.16±28.11and70.06±24.32, respectively. There was significant difference（p<0.001）between theeGFR before and after PCI, they were84.62±71.87and73.60±54.09, respectively.Conclusion：1. Contrast agent in PCI has a certain influence on postprocedural renal function inpatients; postprocedural creatinine was higher than that of preprocedural.Postprocedural eGFR were lower than that of preprocedural.2. Grouping according to the dose of contrast agent, deviding into dose of<150mL group and dose≥150mL group, the difference between two groups on contrastagent dose’s influence on postprocedural creatinine and eGFR was not found. Under thecircumstance of contrast dose less than300mL, with the increase in the contrast dose,the severity of renal injury resulting from contrat agent did not increase.3. There was no difference in the short-medium-term adverse events betweendifferent contrast dose administrating groups. That is, under the circumstance ofcontrast dose less than300mL, increasing the dose of contrast agent did not increaseshort-medium-term adverse events.