Contemporary use of and outcomes associated with ultra‐low contrast volume in patients undergoing percutaneous coronary interventions
dc.contributor.author | Gurm, Hitinder S. | |
dc.contributor.author | Seth, Milan | |
dc.contributor.author | Dixon, Simon R. | |
dc.contributor.author | Michael Grossman, P. | |
dc.contributor.author | Sukul, Devraj | |
dc.contributor.author | Lalonde, Thomas | |
dc.contributor.author | Cannon, Louis | |
dc.contributor.author | West, Daniel | |
dc.contributor.author | Madder, Ryan D. | |
dc.contributor.author | Adam Lauver, D. | |
dc.date.accessioned | 2019-02-12T20:23:05Z | |
dc.date.available | 2020-04-01T15:06:24Z | en |
dc.date.issued | 2019-02-01 | |
dc.identifier.citation | Gurm, Hitinder S.; Seth, Milan; Dixon, Simon R.; Michael Grossman, P.; Sukul, Devraj; Lalonde, Thomas; Cannon, Louis; West, Daniel; Madder, Ryan D.; Adam Lauver, D. (2019). "Contemporary use of and outcomes associated with ultra‐low contrast volume in patients undergoing percutaneous coronary interventions." Catheterization and Cardiovascular Interventions 93(2): 222-230. | |
dc.identifier.issn | 1522-1946 | |
dc.identifier.issn | 1522-726X | |
dc.identifier.uri | https://hdl.handle.net/2027.42/147772 | |
dc.description.abstract | BackgroundThe risk of contrast‐induced acute kidney injury (CI‐AKI) increases in a nonlinear fashion with increasing volume of contrast media. Prior studies recommend limiting contrast volume to less than three times the estimated creatinine clearance (CC). Recently, a number of operators have reported successful percutaneous coronary intervention (PCI) using even lower volumes of contrast.ObjectivesTo evaluate the prevalence and outcomes associated with ultra‐low contrast volume among patients undergoing PCI.MethodsWe assessed the prevalence and outcomes associated with use of ultra‐low contrast volume among 75 393 patients undergoing PCI in Michigan between July 2014 and June 2017 in the BMC2 (Blue Cross Blue Shield of Michigan Cardiovascular Consortium) registry. Ultra‐low contrast volume was defined as contrast volume less than or equal to the patient’s estimated CC. Patients receiving dialysis at the time of the procedure were excluded.ResultsUltra‐low contrast volume was used in 13% of procedures with the majority of these patients being at low risk of renal complications. Compared with patients who received a contrast volume between one and three times the CC, use of ultra‐low volume of contrast was associated with a significantly lower incidence of AKI (aOR 0.682, 95% CI 0.566–0.821, P < 0.001) and a lower incidence of need for dialysis (aOR = 0.341, 95% CI 0.165–0.704, P = 0.003). These benefits were most evident in the patients with a high baseline predicted risk of AKI.ConclusionsA small but clinically significant number of patients are treated with ultra‐low contrast volume. Ultra‐low contrast volume use is associated with a significant reduction in the incidence of AKI or need for dialysis. It may be prudent to consider this new threshold when performing PCI on patients who are at an increased risk of AKI. | |
dc.publisher | John Wiley & Sons, Inc. | |
dc.subject.other | health care outcomes | |
dc.subject.other | PCI | |
dc.subject.other | percutaneous coronary intervention | |
dc.subject.other | renal disease | |
dc.subject.other | contrast agent | |
dc.subject.other | comparative effectiveness/patient centered outcomes research | |
dc.subject.other | complications | |
dc.title | Contemporary use of and outcomes associated with ultra‐low contrast volume in patients undergoing percutaneous coronary interventions | |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | |
dc.subject.hlbsecondlevel | Medicine (General) | |
dc.subject.hlbtoplevel | Health Sciences | |
dc.description.peerreviewed | Peer Reviewed | |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/147772/1/ccd27819.pdf | |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/147772/2/ccd27819_am.pdf | |
dc.identifier.doi | 10.1002/ccd.27819 | |
dc.identifier.source | Catheterization and Cardiovascular Interventions | |
dc.identifier.citedreference | Gurm HS, Seth M, Kooiman J, Share D. A novel tool for reliable and accurate prediction of renal complications in patients undergoing percutaneous coronary intervention. J Am Coll Cardiol. 2013; 61: 2242 – 2248. | |
dc.identifier.citedreference | Harjai KJ, Raizada A, Shenoy C, et al. A comparison of contemporary definitions of contrast nephropathy in patients undergoing percutaneous coronary intervention and a proposal for a novel nephropathy grading system. Am J Cardiol. 2008; 101: 812 – 819. | |
dc.identifier.citedreference | Seeliger E, Sendeski M, Rihal CS, Persson PB. Contrast‐induced kidney injury: Mechanisms, risk factors, and prevention. Eur Heart J. 2012; 33: 2007 – 2015. | |
dc.identifier.citedreference | Kooiman J, Seth M, Nallamothu BK, Heung M, Humes D, Gurm HS. Association between acute kidney injury and in‐hospital mortality in patients undergoing percutaneous coronary interventions. Circ Cardiovasc Interv. 2015; 8: e002212. | |
dc.identifier.citedreference | Brar SS, Aharonian V, Mansukhani P, et al. Haemodynamic‐guided fluid administration for the prevention of contrast‐induced acute kidney injury: The POSEIDON randomised controlled trial. Lancet. 2014; 383: 1814 – 1823. | |
dc.identifier.citedreference | Reed M, Meier P, Tamhane UU, Welch KB, Moscucci M, Gurm HS. The relative renal safety of iodixanol compared with low‐osmolar contrast media: A meta‐analysis of randomized controlled trials. JACC Cardiovasc Interv. 2009; 2: 645 – 654. | |
dc.identifier.citedreference | Naidu SS, Aronow HD, Box LC, et al. SCAI expert consensus statement: 2016 best practices in the cardiac catheterization laboratory: (Endorsed by the cardiological society of India, and sociedad Latino Americana de Cardiologia intervencionista; Affirmation of value by the Canadian Association of interventional cardiology‐Association canadienne de cardiologie d’intervention). Catheter Cardiovasc Interv. 2016; 88: 407 – 423. | |
dc.identifier.citedreference | Gurm HS, Dixon SR, Smith DE, et al. Renal function‐based contrast dosing to define safe limits of radiographic contrast media in patients undergoing percutaneous coronary interventions. J Am Coll Cardiol. 2011; 58: 907 – 914. | |
dc.identifier.citedreference | Kooiman J, Seth M, Share D, Dixon S, Gurm HS. The association between contrast dose and renal complications post PCI across the continuum of procedural estimated risk. PLoS One. 2014; 9: e90233. | |
dc.identifier.citedreference | Gurm HS, Seth M, Dixon S, Kraft P, Jensen A. Trends in contrast volume use and incidence of acute kidney injury in patients undergoing percutaneous coronary intervention: Insights from blue cross blue shield of Michigan cardiovascular collaborative (BMC2). JACC Cardiovasc Interv. 2018; 11: 509 – 511. | |
dc.identifier.citedreference | Kane GC, Doyle BJ, Lerman A, Barsness GW, Best PJ, Rihal CS. Ultra‐low contrast volumes reduce rates of contrast‐induced nephropathy in patients with chronic kidney disease undergoing coronary angiography. J Am Coll Cardiol. 2008; 51: 89 – 90. | |
dc.identifier.citedreference | Nayak KR, Mehta HS, Price MJ, et al. A novel technique for ultra‐low contrast administration during angiography or intervention. Catheter Cardiovasc Interv. 2010; 75: 1076 – 1083. | |
dc.identifier.citedreference | Kline‐Rogers E, Share D, Bondie D, et al. Development of a multicenter interventional cardiology database: The blue cross blue shield of Michigan cardiovascular consortium (BMC2) experience. J Interv Cardiol. 2002; 15: 387 – 392. | |
dc.identifier.citedreference | Moscucci M, Rogers EK, Montoye C, et al. Association of a continuous quality improvement initiative with practice and outcome variations of contemporary percutaneous coronary interventions. Circulation. 2006; 113: 814 – 822. | |
dc.identifier.citedreference | Gurm HS, Seth M, Mehran R, et al. Impact of contrast dose reduction on incidence of acute kidney injury (AKI) among patients undergoing PCI: A modeling study. J Invasive Cardiol. 2016; 28: 142 – 146. | |
dc.identifier.citedreference | Slocum NK, Grossman PM, Moscucci M, et al. The changing definition of contrast‐induced nephropathy and its clinical implications: Insights from the blue cross blue shield of Michigan cardiovascular consortium (BMC2). Am Heart J. 2012; 163: 829 – 834. | |
dc.identifier.citedreference | Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976; 16: 31 – 41. | |
dc.identifier.citedreference | Spruill WJ, Wade WE, Cobb HH 3rd. Continuing the use of the Cockcroft‐Gault equation for drug dosing in patients with impaired renal function. Clin Pharmacol Ther. 2009; 86: 468 – 470. | |
dc.identifier.citedreference | Merlo J, Chaix B, Ohlsson H, et al. A brief conceptual tutorial of multilevel analysis in social epidemiology: Using measures of clustering in multilevel logistic regression to investigate contextual phenomena. J Epidemiol Commun Health. 2006; 60: 290 – 297. | |
dc.identifier.citedreference | Marenzi G, Assanelli E, Campodonico J, et al. Contrast volume during primary percutaneous coronary intervention and subsequent contrast‐induced nephropathy and mortality. Ann Intern Med. 2009; 150: 170 – 177. | |
dc.identifier.citedreference | Lauver DA, Carey EG, Bergin IL, Lucchesi BR, Gurm HS. Sildenafil citrate for prophylaxis of nephropathy in an animal model of contrast‐induced acute kidney injury. PLoS One. 2014; 9: e113598. | |
dc.identifier.citedreference | Brown JR, Robb JF, Block CA, et al. Does safe dosing of iodinated contrast prevent contrast‐induced acute kidney injury? Circ Cardiovasc Interv. 2010; 3: 346 – 350. | |
dc.identifier.citedreference | Freeman RV, O’Donnell M, Share D, et al. Nephropathy requiring dialysis after percutaneous coronary intervention and the critical role of an adjusted contrast dose. Am J Cardiol. 2002; 90: 1068 – 1073. | |
dc.identifier.citedreference | Brown JR, Solomon RJ, Sarnak MJ, et al. Reducing contrast‐induced acute kidney injury using a regional multicenter quality improvement intervention. Circ Cardiovasc Qual Outcomes. 2014; 7: 693 – 700. | |
dc.identifier.citedreference | Mariani J Jr, Guedes C, Soares P, et al. Intravascular ultrasound guidance to minimize the use of iodine contrast in percutaneous coronary intervention: The MOZART (minimizing cOntrast utiliZation with IVUS guidance in coRonary angioplasTy) randomized controlled trial. JACC Cardiovasc Interv. 2014; 7: 1287 – 1293. | |
dc.identifier.citedreference | Ali ZA, Karimi Galougahi K, Nazif T, et al. Imaging‐ and physiology‐guided percutaneous coronary intervention without contrast administration in advanced renal failure: A feasibility, safety, and outcome study. Eur Heart J. 2016; 37: 3090 – 3095. | |
dc.identifier.citedreference | Desch S, Fuernau G, Poss J, et al. Impact of a novel contrast reduction system on contrast savings in coronary angiography—The DyeVert randomised controlled trial. Int J Cardiol. 2018; 257: 50 – 53. | |
dc.identifier.citedreference | Sapontis J, Barron G, Seneviratne S, et al. A first in human evaluation of a novel contrast media saving device. Catheter Cardiovasc Interv. 2017; 90: 928 – 934. | |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.