Short-term rosuvastatin therapy for prevention of contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease
Yaling Han, Guoying Zhu, Lixian Han, Fengxia Hou, Weijian Huang, Huiliang Liu, Jihong Gan, Tiemin Jiang, Xiaoyan Li, Wei Wang, Shifang Ding, Shaobin Jia, Weifeng Shen, Dongmei Wang, Ling Sun, Jian Qiu, Xiaozeng Wang, Yi Li, Jie Deng, Jing Li, Kai Xu, Bo Xu, Roxana Mehran, Yong Huo, Yaling Han, Guoying Zhu, Lixian Han, Fengxia Hou, Weijian Huang, Huiliang Liu, Jihong Gan, Tiemin Jiang, Xiaoyan Li, Wei Wang, Shifang Ding, Shaobin Jia, Weifeng Shen, Dongmei Wang, Ling Sun, Jian Qiu, Xiaozeng Wang, Yi Li, Jie Deng, Jing Li, Kai Xu, Bo Xu, Roxana Mehran, Yong Huo
Abstract
Objectives: This study sought to evaluate the safety and efficacy of rosuvastatin in preventing contrast-induced acute kidney injury (CI-AKI) in patients with diabetes mellitus (DM) and chronic kidney disease (CKD).
Background: CI-AKI is an important complication after contrast medium injection. While small studies have shown positive results with statin therapy, the role of statin therapy in prevention of CI-AKI remains unknown.
Methods: We randomized 2,998 patients with type 2 DM and concomitant CKD who were undergoing coronary/peripheral arterial angiography with or without percutaneous intervention to receive rosuvastatin, 10 mg/day (n = 1,498), for 5 days (2 days before, and 3 days after procedure) or standard-of-care (n = 1,500). Patients' renal function was assessed at baseline, 48 h, and 72 h after exposure to contrast medium. The primary endpoint of the study was the development of CI-AKI, which was defined as an increase in serum creatinine concentration ≥0.5 mg/dl (44.2 μmol/l) or 0.25% above baseline at 72 h after exposure to contrast medium.
Results: Patients randomized to the rosuvastatin group had a significantly lower incidence of CI-AKI than controls (2.3% vs. 3.9%, respectively; p = 0.01). During 30 days' follow-up, the rate of worsening heart failure was significantly lower in the patients treated with rosuvastatin than that in the control group (2.6% vs. 4.3%, respectively; p = 0.02).
Conclusions: Rosuvastatin significantly reduced the risk of CI-AKI in patients with DM and CKD undergoing arterial contrast medium injection. (Rosuvastatin Prevent Contrast Induced Acute Kidney Injury in Patients With Diabetes [TRACK-D]; NCT00786136).
Keywords: CI-AKI; CKD; DM; LDL-C; ST-segment elevation myocardial infarction; STEMI; TC; angiography; chronic kidney disease; contrast medium; contrast-induced acute kidney injury; diabetes mellitus; eGFR; estimated glomerular filtration rate; high-sensitivity C-reactive protein; hsCRP; kidney; low-density lipoprotein cholesterol; sCr; serum creatinine; statins; total cholesterol.
Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Source: PubMed