ISSN 2149-2263 | E-ISSN 2149-2271
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The effects of chronic usage of enzyme inhibitors and angiotensin receptor blockers on contrast-induced nephropathy in low-risk patients [Anatol J Cardiol]
Anatol J Cardiol. 2013; 13(3): 245-250 | DOI: 10.5152/akd.2013.050

The effects of chronic usage of enzyme inhibitors and angiotensin receptor blockers on contrast-induced nephropathy in low-risk patients

Nezihi Barış1, Ebru Özpelit1, Nazile Bilgin Doğan1, Hande Kangül1, Sefa Gül1, Bahri Akdeniz1, Sema Güneri1
Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, İzmir-Turkey

Objective: There is conflicting data about the role of renin- angiotensin- aldosterone system (RAAS) blockers in contrast-induced nephropathy (CIN) pathophysiology. In this study, we aimed to investigate the effects of chronic usage of RAAS blocker drugs on development of CIN in low risk patients. Methods: Study was designed as a prospective cohort study. A total of 295 patients were enrolled in the study. Study population was consisted of three subgroups according to prior usage of RAAS blockers: no RAAS blocker group (n=95), angiotensin-converting enzyme inhibitor (ACEI) group (n=106), angiotensin receptor blocker (ARB) group (n=94). CIN was defined as an increase of ≥25% in creatinine over the baseline value or 0.5 mg/dL rise within 48-72 h of angiography. Mehran score was calculated for each patient. Baseline variables and percentage of CIN were compared with ANOVA, Mann-Whitney U, Kruskal-Wallis and Pearson Chi-square tests between groups. In order to determine the independent predictors of CIN, binary logistic regression analyses were performed. Results: CIN occurred in 18 patients (17.0%) in the ACEI group, 17 patients (18.1%) in ARB group and 7 patients (7.4%) in the no RAAS group. CIN occurrence was significantly higher in RAAS than no RAAS group (17.5% vs. 7.4%, p=0.01). Chronic RAAS blocker administration was an independent predictor of CIN (OR=2.69; 95% CI: 1.025-7.067; p=0.04). Mehran score was the only other independent predictor for CIN (OR=1.15; 95% CI: 1.019-1.310; p=0.02). Conclusion: In patients with near normal renal functions who are undergoing elective coronary procedure, chronic usage of ACEI and ARB increases the risk of CIN.

Keywords: Contrast-induced nephropathy, angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, regression analysis

Nezihi Barış, Ebru Özpelit, Nazile Bilgin Doğan, Hande Kangül, Sefa Gül, Bahri Akdeniz, Sema Güneri. The effects of chronic usage of enzyme inhibitors and angiotensin receptor blockers on contrast-induced nephropathy in low-risk patients. Anatol J Cardiol. 2013; 13(3): 245-250
Manuscript Language: English


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