evrazkarЕвразийский Кардиологический ЖурналEurasian heart journal2225-16852305-0748Евразийская ассоциация кардиологов10.38109/2225-1685-2020-4-6-10evrazkar-6231Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL PAPERSКОНТРАСТ-ИНДУЦИРОВАННОЕ ОСТРОЕ ПОВРЕЖДЕНИЕ ПОЧЕК ПОСЛЕ ЧРЕСКОЖНЫХ КОРОНАРНЫХ ВМЕШАТЕЛЬСТВ У ПАЦИЕНТОВ СО СТАБИЛЬНОЙ ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦАCONTRAST-INDUCED ACUTE KIDNEY INJURY AFTER PERCUTANEOUS CORONARY INTERVENTIONS IN PATIENTS WITH STABLE CORONARY ARTERY DISEASEhttps://orcid.org/0000-0002-5820-1759МироноваО. Ю.MironovaO. Iu.

к.м.н., доцент кафедры факультетской терапии №1 Института клинической медицины им. Н. В. Склифосовского

119435, г. Москва, ул. Большая Пироговская, д. 6, стр. 1

Cand. of Sci. (Med.), docent of the Department of Faculty Therapy No. 1 of the Institute of Clinical Medicinenamed after N.V. Sklifosovsky

119435, Moscow, st. Bol. Pirogovskaya, 6, bldg. 1

mironova_o_yu@staff.sechenov.ruhttps://orcid.org/0000-0002-2682-4417ФоминВ. В.FominV. V.

член-корр. РАН, профессор, д.м.н., проректор по клинической работе и дополнительному профессиональному образованию, заведующий кафедрой факультетской терапии №1

119435, г. Москва, ул. Большая Пироговская, д. 6, стр. 1

119435, Moscow, st. Bol. Pirogovskaya, 6, bldg. 1

ФГАОУ Первый МГМУ им. И. М. Сеченова (Сеченовский университет) МЗ РФРоссияFirst Moscow State Medical University I.M. Sechenova (Sechenov University)Russian Federation20203012202004610Copyright © Миронова О.Ю., Фомин В.В., 20202020Миронова О.Ю., Фомин В.В.Mironova O.I., Fomin V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.heartj.asia/jour/article/view/6231Цель исследования

Цель исследования. Целью исследования стало сравнить частоту развития КИ-ОПП среди пациентов со стабильной ИБС в 2012 и в 2017 годах.

Материал и методы

Материал и методы. В наблюдательное открытое когортное проспективное  исследование были включены 1023 пациента со стабильной ИБС, имеющие показания к проведению исследований с внутриартериальным введением контрастного вещества. Из них 561 в 2012 году и 462 в 2017 году. Работа зарегистрирована в системе ClinicalTrials. gov под номером NCT04014153. Профилактика КИ-ОПП пациентам с высоким риском проводилась с помощью введения раствора 0,9% натрия хлорида внутривенно капельно со скоростью 1 мл/кг/ч, а пациентам, страдающим сердечной недостаточностью, со скоростью 0,5 мл/кг/ч до и после вмешательства. Пациенты, включенные в исследование в 2017 году, были старше, имели более высокий ИМТ и большее количество факторов риска КИ-ОПП. Первичной конечной точкой являлось развитие КИ-ОПП.

Результаты

Результаты. Частота развития КИ-ОПП статистически достоверно снизилась более, чем в 3 раза в 2017 году, по сравнению с 2012 (6% и 18,5% соответственно) (р<0,0001), несмотря на увеличение возраста пациентов, более частый прием метформина и увеличение количества факторов риска.

Вывод

Вывод. Частота КИ-ОПП снизилась в 3 раза в 2017 году по сравнению с 2012 (6% и 18,5% соответственно), несмотря на увеличение возраста пациентов и количества имеющихся у них факторов риска. Полученного результата удалось добиться с помощью повышения осведомленности врачей об этом синдроме, мерах его профилактики и лечения.

Aim

Aim. The aim of the study was to assess the incidence of CI-AKI in patients with stable CAD in 2012 and 2017 respectively.

Materials and methods

Materials and methods. 1023 patients with stable CAD and indications to the interventions with intraarterial contrast media administration were included in the study. 561 patients were enrolled in the study in 2012 and 462 in 2017 respectively& We conducted a prospective open cohort study (ClinicalTrials.gov NCT04014153). Preventive measures included the administration of 0,9% saline with the speed 1 ml/kg/h intravenously and 0,5 kg/ml/h for the patients with heart failure before and after the procedure. The patients enrolled in 2017 were older, had higher BMI and more risk factors of CI-AKI development. The primary endpoint was the development of CI-AKI.

Results

Results. The rate of CI-AKI decreased by more than 3 times in 2017 in comparison with 2012 (6% vs. 18,5% respectively), in spite of the increase of the age of patients, increased use of metformin and higher number of risk factors. The difference was statistically significant (р<0,0001).

Conclusion

Conclusion. The prevalence of CI-AKI decreased 3 times in 2017 in comparison with 2012 (6% vs. 18,5% respectively), in spite of the increase of the age of patients and the number of their comorbidities. These results were obtained due to higher level of education of the doctors about the syndrome, preventive measures and methods of treatment.

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The authors declare that there are no conflicts of interest present.