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Association of less-contrast media with clinical factors in elective percutaneous coronary intervention

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Abstract

Since the amount of contrast media during percutaneous coronary intervention (PCI) is closely related to the exacerbation of renal function, it should be important to reduce the dose of contrast media during PCI. The purpose of this retrospective study was to evaluate the association of less-contrast media with clinical factors in elective PCI. A total of 709 patients were divided into the less-contrast media group (n = 142) and the conventional-contrast media group (n = 567) according to the quintile of total contrast volume. Univariate and multivariate logistic regression analyses were performed to find associations between the clinical variables and the less-contrast media group. The intravascular ultrasound (IVUS) use rate in the study population was considerably high (94.9%). In multivariable logistic regression analysis, an eGFR < 30 mL/min/1.73 m2 without hemodialysis was significantly associated with the less-contrast media group [odds ratio (OR) 43.73, 95% confidence interval (CI) 14.05–136.09, P < 0.001]. Left main-left anterior descending artery lesion (OR 0.28, 95% CI 0.17–0.48, P < 0.001), bifurcation lesion (OR 0.39, 95% CI 0.16–0.92, P = 0.03), chronic total occlusion (OR 0.22, 95% CI 0.06–0.90, P = 0.03) were inversely associated with the less-contrast media group. In conclusion, complex lesion characteristics were inversely associated with the less-contrast media in elective PCI. Since operators could access patients’ renal function before elective procedure, an eGFR < 30 mL/min/1.73 m2 was most significantly associated with the less-contrast media. Our results suggest the possibility that the amount of contrast media is controllable in current PCI under IVUS-guidance.

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Acknowledgements

The authors acknowledge all staff in the catheter laboratory in Saitama Medical Center, Jichi Medical University for their technical support in this study.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, 330-8503, Japan

    Yasuhiro Mukai, Kenichi Sakakura, Kei Yamamoto, Yousuke Taniguchi, Takunori Tsukui, Masaru Seguchi, Hiroshi Wada, Shin-ichi Momomura & Hideo Fujita

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  1. Yasuhiro Mukai
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  2. Kenichi Sakakura
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  3. Kei Yamamoto
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  4. Yousuke Taniguchi
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  5. Takunori Tsukui
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  6. Masaru Seguchi
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  7. Hiroshi Wada
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  8. Shin-ichi Momomura
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  9. Hideo Fujita
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Correspondence to Kenichi Sakakura.

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Mukai, Y., Sakakura, K., Yamamoto, K. et al. Association of less-contrast media with clinical factors in elective percutaneous coronary intervention. Heart Vessels 35, 143–152 (2020). https://doi.org/10.1007/s00380-019-01473-3

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  • DOI: https://doi.org/10.1007/s00380-019-01473-3

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