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Incidence of persistent renal dysfunction after contrast enhanced coronary CT angiography in patients with suspected coronary artery disease

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Abstract

Contrast-induced nephropathy (CIN) is a potentially serious complication of contrast agents used in computed tomography angiography (CTA). The aim of this study was to evaluate whether persistent renal dysfunction occurs in patients undergoing coronary CTA for suspected stable coronary artery disease (CAD). From a cohort of 957 patients undergone coronary CTA, we identified 402 patients with plasma creatinine levels collected before and within 6 months after CTA. According to the definition of CIN, patients with a ≥25 % increase in plasma creatinine after CTA were evaluated. The post-CTA measurements in 402 patients (195 men, age 62.9 ± 9.3 years) were performed at a median of 99 days after CTA. On average, there was no change in plasma creatinine level between the pre- and post-CTA measurements (75.8 ± 16.0 and 75.7 ± 16.4 µmol/L, respectively; P = 0.63) but both increases and decreases were commonly detected. Fourteen (3.5 %) patients had a ≥25 % increase in plasma creatinine levels after CTA. A more detailed evaluation of these patients revealed that in 4 patients the increase was explained by other morbidities, whereas in 9 patients the creatinine level returned to the previous levels at later follow-up (median time to normalization: 311 days). Only in 1 (0.2 %) remaining patient, there was a persistent increase in plasma creatinine level, possibly related to the iodine contrast agent exposure. Alterations in plasma creatinine concentration occur frequently. Persistent renal dysfunction attributable to iodine contrast agent exposure is rare in patients referred to coronary CTA for suspected CAD.

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Funding

This study was supported by the Academy of Finland Centre of Excellence on Cardiovascular and Metabolic Diseases; the Finnish Foundation for Cardiovascular Research; and the Turku University Hospital.

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Authors and Affiliations

  1. Turku PET Centre, Turku University Hospital, University of Turku, P.O. Box 52, Kiinamyllynkatu 4–8, 20521, Turku, Finland

    Teemu Maaniitty, Iida Stenström, Valtteri Uusitalo, Sami Kajander, Antti Saraste & Juhani Knuuti

  2. Heart Center, Turku University Hospital, Turku, Finland

    Heikki Ukkonen & Antti Saraste

  3. Department of Clinical Physiology, Nuclear Medicine and PET, Turku University Hospital, Turku, Finland

    Juhani Knuuti

  4. Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands

    Jeroen J. Bax

Authors
  1. Teemu Maaniitty
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  2. Iida Stenström
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  3. Valtteri Uusitalo
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  4. Heikki Ukkonen
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  5. Sami Kajander
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  6. Jeroen J. Bax
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  7. Antti Saraste
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  8. Juhani Knuuti
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Corresponding author

Correspondence to Juhani Knuuti.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Conflict of interest

Dr. Bax reports that the department of Cardiology (Leiden University Medical Center, The Netherlands) has received unrestricted research grants from Medtronic, Biotronik, Boston Scientific and Edwards Lifesciences. Dr. Saraste reports grants from the Academy of Finland and the Finnish Foundation for Cardiovascular Research, during the conduct of the study; personal fees from GE Healthcare, Novartis, Abbot, Actelion, Pfizer and Lilly, outside the submitted work. Dr. Knuuti reports grants from Cardirad and personal fees from Lantheus inc, outside the submitted work.

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Maaniitty, T., Stenström, I., Uusitalo, V. et al. Incidence of persistent renal dysfunction after contrast enhanced coronary CT angiography in patients with suspected coronary artery disease. Int J Cardiovasc Imaging 32, 1567–1575 (2016). https://doi.org/10.1007/s10554-016-0935-8

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  • DOI: https://doi.org/10.1007/s10554-016-0935-8

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