The Effect Of Coronary Angiography And Coronary CT Angiography On CI-AKI

BackgroundCoronary atherosclerotic heart disease is one of the diseases with tihe highest mortality rate in China.At present,the degree of eoronary artery stenosis is mainly determined by coronary angiography and coronary CT angiography,etc.,both of which can produce contrast agent exposure to patients,but the administration methods are different.Contrast-induced acute kidney injury(Cl-AKI)caused by the use of iodine contrast agent is also increasingly common,and has become the third cause of hospitalized acute kidney injury.Currently,there is no effective treatment for ci-aki,so it is particularly important to accurately assess high-risk factors and take appropriate preventive measures to reduce their occurrence.At present,there are few studies on the difference between angiography and arterial and intravenous injection on the effect of early renal function,and it is not clear whether the administration of different routes is related to the occurrence of CI-AKI.ObjectiveOur study was main to investigate the coronary artery angiography and CT coronary artery imaging after early renal function changes of the relationship,and compare the high blood pressure,diabetes,renal insufficiency,heart failure and other Cl-AKI contrast media exposure risk groups in these two different ways of the early renal function changes and Cl-AKI before and after the relationship,in order to seek reasonable security for coronary heart disease(CHD)provide theoretical basis for the diagnostics,and coronary artery angiography and CT coronary artery imaging provide reference for different risk assessment standard.Materials and Methods249 patients who diagnosed with chest distress between January 2018 and June 2018 in our hospital wasselectedonourstudy.They were divided into coronary angiography group(CAG group),coronary CT imaging group(CCTA group)and general CT plain scan group(CT group)according to the improved exanination after admission.Using single factor and multiple sets of methods such as comparative analysis between the three groups of age,sex,hypertension,diabetes,cardiac insufficiency,renal insufficiency,heart failure and other clinical therapy and urinary inhibition C,ereatinine,urea nitrogen,glycosylated hemoglobin,low density lipoprotein,cholesterol,uric acid,hypersensitive c-reactive protein and other laboratory examination indexes.Early renal function(creatinine and eGFR)changes and the incidence of ci-aki were compared among the three groups.Hypertension,diabetes,renal insufficiency,and heart failure were compared among the three groups Results1.Age,gender,hypertension,diabetes,cardiac insufficiency,renal insufficiency,heart failure,creatinine,cystatin C,urea nitrogen,glycosylated hemoglobin,low-density lipoprotein,cholesterol,uric acid,and hypersensitive c-reactive protein showed no statistical difference among the three groups(p>0.05).2.Compared with the CT group,early creatinine increased in the CAG group and the CCTA group,and the corresponding eGFR decreased(p<0.05).There was no difference between the CAG group and the CCTA group in the incidence of early creatinine increase and ci-aki(p>0.05).3.In patients with diabetic renal insufficiency and heart failure,creatinine increased significantly in the CAG group compared with that in the CCTA group(p<0.05),and corresponding eGFR decreased significantly(p<0.05).The incidence of CI-AKI in the CAG group was higher than that in the CCTA group(p<0.05)Conclusion1.Both coronary angiography and coronary CT showed a decrease in early renal function after the use of contrast media.2.In patients with diabetes mellitus,renal insufficiency and heart failure,the early decrease of renal function after coronary angiography was more obvious than that of coronary CT imaging3.The incidence of contrast-related acute kidney injury in heart failure patients is higher than that of coronary CT.