Table 1:
Baseline: characteristics of study participants by cardiovascular events.
| No. (%) | |||
|---|---|---|---|
| Characteristics | Cardiovascular eventa (n = 119) | No cardiovascular event (n = 803) | P-value |
| Age, years, mean ± SD | 71.2 ± 8.4 | 69.9 ± 7.9 | .12 |
| Male sex | 117 (98.3) | 772 (96.1) | .38 |
| Race/ethnicity | |||
| White | 93 (78.1) | 619 (77.1) | .78 |
| Black | 17 (14.3) | 127 (15.8) | |
| Hispanic | 4 (3.4) | 27 (3.4) | |
| Other | 5 (4.2) | 21 (2.6) | |
| Weight, kilograms, mean ± SD | 98.3 ± 23.3 | 100.7 ± 21.8 | .14 |
| Baseline serum creatinine, mg/dL, median (IQR) | 1.59 (1.33–1.98) | 1.48 (1.28–1.73) | .002 |
| Baseline urine creatinine, mg/dL, median (IQR) | 76.80 (54.40–110.40) | 93.05 (65.10–128.05) | .006 |
| Baseline post-operative urine creatinine, mg/dL, median (IQR) | 56.10 (36.90–81.35) | 56.95 (38.90–79.50) | .58 |
| UACR categories, mg/g | |||
| <30 | 33 (27.7) | 335 (41.7) | .0006 |
| 30–300 | 35 (29.4) | 249 (31.0) | |
| >300 | 41 (34.4) | 163 (20.3) | |
| Baseline eGFR, mL/min/1.73m2 | |||
| 15–30 | 16 (13.4) | 52 (6.5) | .020 |
| 30–45 | 41 (34.4) | 271 (33.7) | |
| >45 | 59 (49.6) | 457 (56.9) | |
| Comorbid conditions | |||
| Heart failure | 67 (56.3) | 297 (36.9) | <.001 |
| Diabetes mellitus | 100 (84.0) | 652 (81.2) | .59 |
| Myocardial infarction | 47 (39.5) | 263 (32.7) | .16 |
| Peripheral vascular disease | 45 (37.8) | 246 (30.6) | .13 |
| Cerebrovascular disease | 25 (21.0) | 126 (15.7) | .15 |
| Chronic pulmonary disease | 37 (31.1) | 193 (24.2) | .11 |
| Hypertension | 113 (94.9) | 745 (92.8) | .59 |
| Angiographic procedure | |||
| Coronary | 110 (92.4) | 695 (86.5) | .13 |
| Carotid | 0 | 7 (0.9) | |
| Peripheral | 4 (3.3) | 75 (9.3) | |
| Mesenteric | 0 | 0 | |
| Aortic and/or iliac | 2 (1.7) | 10 (1.2) | |
| Pulmonary | 0 | 0 | |
| Renal | 1 (0.8) | 3 (0.4) | |
| Other | 1 (0.8) | 4 (0.5) | |
| Percutaneous intervention | 28 (23.5) | 224 (27.9) | .30 |
| LVEDP, mmHg, mean ± SD | 19.9 ± 8.5 | 19.3 ± 8.3 | .53 |
| Intervention arm | |||
| Saline + placebo | 22 (18.5) | 188 (23.4) | .29 |
| Saline + NAC | 37 (31.1) | 198 (24.5) | |
| Sodium bicarbonate + placebo | 34 (24.0) | 205 (25.5) | |
| Sodium bicarbonate + NAC | 26 (21.8) | 205 (25.5) | |
| Contrast type | |||
| Iodixanol | 52 (43.7) | 431 (53.7) | .03 |
| Low-osmolal agent | 66 (55.5) | 360 (44.8) | |
| Contrast volume, mL, mean ± SD | 106.8 ± 60.1 | 106.9 ± 67.8 | .52 |
| AKI stageb | |||
| No AKI | 114 (95.8) | 744 (92.7) | .10 |
| Stage 1 | 1 (0.8) | 12 (1.5) | |
| Stage 2 | 4 (3.4) | 26 (3.2) | |
| Stage 3 | 0 | 21 (2.6) | |
| CA-AKIc | 14 (11.7) | 59 (7.3) | .10 |
| MAKE or death by day 90d | 33 (27.7) | 26 (3.2) | <.001 |
| Death | 28 (23.5) | 0 (0) | |
| Need for dialysis | 5 (4.2) | 7 (0.9) | .01 |
| ≥50% in serum creatinine from baseline | 5 (4.2) | 58 (7.2) | .22 |
AKI, acute kidney injury; CA-AKI, contrast-associated acute kidney injury; eGFR, estimated glomerular filtration rate; IQR, interquartile range; LVEDP, left ventricular end-diastolic pressure; MAKE, major adverse kidney events; NAC, N-acetylcysteine; SD, standard deviation; UACR, urine albumin-creatinine ratio.
Cardiovascular event(s) within 90 days is defined as a composite of either a primary or secondary diagnosis of the acute coronary syndrome, ST-elevation myocardial infarction, non-ST segment elevation myocardial infarction, unstable angina, congestive heart failure, cerebrovascular accident, or death.
Stages of AKI were defined by Kidney Disease: Improving Global Outcome criteria: stage 1: increase in serum creatinine to 1.5–1.9 times baseline or increase in serum creatinine by ≥0.3 mg/dl; stage 2: increase in serum creatinine to 2.0–2.9 times baseline; stage 3: increase in serum creatinine to 3.0 times baseline or increase in serum creatinine to ≥4.0 mg/dl or need for dialysis. Ninety-six participants were missing either (or both) the baseline or 3- to 5-day serum creatinine and are presumed to have no AKI.
Contrast-associated acute kidney injury was defined as an increase in serum creatinine level ≥25% or ≥0.5 mg/dL from the baseline 3 to 5 days after angiography.
Major adverse kidney events were defined as a composite of death, persistent kidney dysfunction, or dialysis dependence by day 90. A persistent decrease in kidney function was defined as a ≥50% increase in serum creatinine level at day 90 after angiography, confirmed by subsequent testing within 14 days of the initial measurement [10, 11].