Contrast-associated acute kidney injury and cardiovascular events: a secondary analysis of the PRESERVE cohort

Background Contrast-associated acute kidney injury (CA-AKI) has been associated with a higher risk of cardiovascular (CV) events. We studied the risk of CV events in chronic kidney disease (CKD) patients undergoing angiography and whether biomarkers can predict such events. We also explored whether...

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Bibliographic Details
Published in:Clinical kidney journal 2023-12, Vol.16 (12), p.2626-2638
Main Authors: Murugan, Raghavan, Boudreaux-Kelly, Monique Y, Kellum, John A, Palevsky, Paul M, Weisbord, Steven
Format: Article
Language:English
Subjects:
Analysis
Angiography
C-reactive protein
Chronic kidney failure
Mediation
Medical research
Medicine, Experimental
Natriuretic peptides
Protein binding
Risk factors
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Summary:Background Contrast-associated acute kidney injury (CA-AKI) has been associated with a higher risk of cardiovascular (CV) events. We studied the risk of CV events in chronic kidney disease (CKD) patients undergoing angiography and whether biomarkers can predict such events. We also explored whether CA-AKI mediates the association of pre-angiography estimated glomerular filtration rate (eGFR) on CV events. Methods We analysed participants from the Prevention of Serious Adverse Events following the Angiography (PRESERVE) trial. Urinary tissue inhibitor of matrix metalloproteinase [TIMP]-2 and insulin growth factor binding protein [IGFBP]-7, plasma brain-type natriuretic peptide (BNP), high sensitivity C-reactive protein (hs-CRP), and serum cardiac troponin-I (Tn-I) were assayed before and after angiography. We assessed the composite risk of CV events by day 90. Results Of the 922 participants, 119 (12.9%) developed CV events, and 73 (7.9%) developed CA-AKI. Most cases of CA-AKI (90%) were stage 1. There were no differences in urinary [TIMP-2]•[IGFBP7] concentrations or the proportion of patients with CA-AKI among those with and without CV events. Higher BNP, Tn-I, and hs-CRP were associated with CV events, but their discriminatory capacity was modest (AUROC
ISSN:2048-8505
2048-8513
DOI:10.1093/ckj/sfad214