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Statins in the Prevention of Contrast-Induced Nephropathy

  • Anthony C. Chyou
  • Anay Thodge
  • Dmitriy N. Feldman
  • Rajesh V. SwaminathanEmail author
Coronary Artery Disease (D Feldman and V Voudris, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Coronary Artery Disease

Opinion statement

Coronary angiography and percutaneous coronary interventions are common procedures that utilize iodinated contrast medium to visualize the coronary arterial tree and treat stable and unstable ischemic heart syndromes. Exposure to contrast agents can cause acute and persistent worsening of renal function leading to increased morbidity and mortality. Certain patient characteristics such as age, presence of diabetes, congestive heart failure, chronic kidney disease, hemodynamic instability on presentation, and type and volume of contrast used can increase the risk of developing contrast-induced nephropathy (CIN) and its subsequent complications. Despite the lack of a universal definition, CIN is typically defined as an increase in serum creatinine ≥0.5 mg/dL or 25 % above baseline 48 to 72 h after contrast exposure. Previous research has shown the benefits of adequate intravenous hydration with iso-osmolar crystalloids and the importance of limiting the amount of low-osmolar and iso-osmolar contrast used to prevent the development of CIN. 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have anti-inflammatory and anti-apoptotic properties with few side effects, making it an attractive therapeutic option for prevention of CIN. A number of trials have examined the benefit of different types of statins, high-dose versus low-dose statins, loading versus chronic dosing of statins, in various clinical presentations including acute coronary syndromes and elective procedures, and in those with associated comorbidities such as anemia and chronic kidney disease. In this review, we will summarize recent data regarding statin therapy for prevention of contrast-induced nephropathy.

Keywords

Contrast-induced nephropathy Prevention Statins 

Notes

Acknowledgments

This investigation was supported by grant UL1TR000457 of the Clinical and Translational Science Center at Weill Cornell Medical College.

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Anthony C. Chyou, Dr. Anay Thodge, and Dr. Rajesh V. Swaminathan each declare no potential conflicts of interest.

Dr. Dmitriy N. Feldman is a section editor for Current Treatment Options in Cardiovascular Medicine.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Anthony C. Chyou
    • 1
  • Anay Thodge
    • 2
  • Dmitriy N. Feldman
    • 1
    • 3
  • Rajesh V. Swaminathan
    • 1
    • 3
    Email author
  1. 1.Greenberg Division of CardiologyWeill Cornell Medical College, New York-Presbyterian HospitalNew YorkUSA
  2. 2.Wayne State University School of MedicineDetroitUSA
  3. 3.Cardiac Catheterization LaboratoriesWeill Cornell Medical CollegeNew YorkUSA

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