摘要
Background:Current randomized trials have demonstrated the effects of short-term rosuvastatin therapy in preventing contrast-induced acute kidney injury (CIAKI).However,the consistency of these effects on patients administered different volumes of contrast media is unknown.Methods:In the TRACK-D trial,2998 patients with type 2 diabetes and concomitant chronic kidney disease (CKD) who underwent coronary/peripheral arterial angiography with or without percutaneous intervention were randomized to short-term (2 days before and 3 days after procedure) rosuvastatin therapy or standard-of-care.This prespecified analysis compared the effects of rosuvastatin versus standard therapy in patients exposed to (moderate contrast volume [MCV],200-300 ml,n =712) or (high contrast volume [HCV],≥300 ml,n =220).The primary outcome was the incidence of CIAKI.The secondary outcome was a composite of death,dialysis/hemofiltration or worsened heart failure at 30 days.Results:Rosuvastatin treatment was associated with a significant reduction in CIAKI compared with the controls (2.1％ vs.4.4％,P =0.050) in the overall cohort and in patients with MCV (1.7％ vs.4.5％,P =0.029),whereas no benefit was observed in patients with HCV (3.4％ vs.3.9％,P =0.834).The incidence of secondary outcomes was significantly lower in the rosuvastatin group compared with control group (2.7％ vs.5.3％,P =0.049) in the overall cohort,but it was similar between the patients with MCV (2.0％ vs.4.2％,P =0.081) or HCV (5.1％ vs.8.8％,P =0.273).Conclusions:Periprocedural short-term rosuvastatin treatment is effective in reducing CIAKI and adverse clinical events for patients with diabetes and CKD after their exposure to a moderate volume of contrast medium.
Background:Current randomized trials have demonstrated the effects of short-term rosuvastatin therapy in preventing contrast-induced acute kidney injury (CIAKI).However,the consistency of these effects on patients administered different volumes of contrast media is unknown.Methods:In the TRACK-D trial,2998 patients with type 2 diabetes and concomitant chronic kidney disease (CKD) who underwent coronary/peripheral arterial angiography with or without percutaneous intervention were randomized to short-term (2 days before and 3 days after procedure) rosuvastatin therapy or standard-of-care.This prespecified analysis compared the effects of rosuvastatin versus standard therapy in patients exposed to (moderate contrast volume [MCV],200-300 ml,n =712) or (high contrast volume [HCV],≥300 ml,n =220).The primary outcome was the incidence of CIAKI.The secondary outcome was a composite of death,dialysis/hemofiltration or worsened heart failure at 30 days.Results:Rosuvastatin treatment was associated with a significant reduction in CIAKI compared with the controls (2.1％ vs.4.4％,P =0.050) in the overall cohort and in patients with MCV (1.7％ vs.4.5％,P =0.029),whereas no benefit was observed in patients with HCV (3.4％ vs.3.9％,P =0.834).The incidence of secondary outcomes was significantly lower in the rosuvastatin group compared with control group (2.7％ vs.5.3％,P =0.049) in the overall cohort,but it was similar between the patients with MCV (2.0％ vs.4.2％,P =0.081) or HCV (5.1％ vs.8.8％,P =0.273).Conclusions:Periprocedural short-term rosuvastatin treatment is effective in reducing CIAKI and adverse clinical events for patients with diabetes and CKD after their exposure to a moderate volume of contrast medium.
