Impact of Blood Glucose Levels on Contrast Induced Nephropathy after Percutaneous Coronary Intervention in Patients not known to be Diabetic with Acute Coronary Syndrome.
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Date
2013
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Abstract
Background: Contrast-Induced Nephropathy (CIN) is an iatrogenic disorder, resulting from exposure to
contrast media. The association between pre-procedural blood glucose levels and CI-AKI risk (regardless
of pre-existing diabetes) is unknown. The present study was conducted to evaluate the incidence of CI-AKI
in patients with admission hyperglycemia in non-diabetic ACS patients.
Methods: This is Prospective, observational study done in the department of Cardiology, National Institute
of Cardiovascular Diseases (NICVD), Dhaka. Considering inclusion and exclusion criteria, 50 patients
were non diabetic with ACS with normal blood glucose (d”7.8 mmol/l or d”140 mg/dl) in (Group I) and 50
patients were non diabetic with ACS with high blood glucose (>7.8 mmol/l or >140 mg/dl) undergoing
percutaneous coronary intervention in (Group II). On admission random blood glucose was measured.
Non- ionic low osmolar contrast agents (lopamidol) was used in all patients. Serum creatinine, serum
electrolytes was measured and creatinine clearance rate was determined within 24 hours before PCI and
day 1 and 2 after PCI.
Results: The incidence of CIN was 24% in high blood glucose group and 4% in normal blood glucose group
(p=0.004). It was also observed that gradual incremental increase in risk of CIN associated with higher
admission blood glucose level. There was positive correlation between s. creatinine and admission blood
glucose but it showed negative correlation between CCr and admission blood glucose after PCI in ACS
patients not known to be diabetic.
Conclusion: The present study reveals that index admission high blood glucose in acute coronary syndrome
patients not known to be diabetic is associated with increased incidence of contrast induced nephropathy
after percutaneous coronary intervention.
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Keywords
Blood glucose, Contrast induced nephropathy, Acute coronary syndrome, PCI
Citation
Islam N, Majumder A A S, Khalequzzaman M, Akhtaruzzaman M, Choudhury A K, Ali M S, Shikder M R, Hasem S, Nobi A B M N, Kabir M S. Impact of Blood Glucose Levels on Contrast Induced Nephropathy after Percutaneous Coronary Intervention in Patients not known to be Diabetic with Acute Coronary Syndrome. Cardiovascular Journal. 2013; 6(1): 23-30.