- 作者：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 ; et al.
- 关键词：angiography ; contrast medium ; diabetes mellitus ; kidney ; statins
- 刊名：Journal of the American College of Cardiology
- 出版年：7-14 January, 2014
- 年：2014
- 卷：63
- 期：1
- 页码：62-70
- 全文大小：734 K
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聽= 1,498), for 5聽days (2 days before, and 3 days after procedure) or standard-of-care (n聽= 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 鈮?.5 mg/dl (44.2聽渭mol/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聽= 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]; )