ESC 2013:韩雅玲教授发现瑞舒伐他汀可显著降低DM合并慢性肾病患者的对比剂急性肾损伤风险
2013-09-03 MedSci MedSci原创
研究要点： 造影剂急性肾损伤（CIAKI)是使用造影剂的重要并发症，此前已有小型研究结果显示，他汀类药物治疗可减少CIAKI发病风险，但他汀治疗对CIAKI的预防作用尚不明确。 这项研究表明，罗素伐他汀可显著降低糖尿病合并慢性肾脏病患者CIAKI发生率。 韩雅玲
研究要点：
这项研究的对象为2998名2型糖尿病合并慢性肾脏病患者，所有患者均曾接受冠脉或周边血管血管造影。研究人员将这些患者随机分成两组，一组患者接受罗素伐他汀治疗五天（10mg／d，造影前使用2天，造影后使用三天）；一组患者接受标准治疗。研究人员分别评估了患者的基础肾功能以及血管造影后48或72小时的肾功能水平。本次研究的主要终点是发生造影剂急性肾损伤（血管造影后，血肌酐浓度增加 ≥0.5mg/dL或与72小时增高幅度≥25%）。 研究结果表明，接受罗素伐他汀治疗的患者组别CIAKI发生率要显著低于对照组；试验组心衰恶化要显著低于对照组。其他主要不良心血管事件发生率两组之间没有显著差异。 这项研究表明，罗素伐他汀可显著降低糖尿病合并慢性肾脏病患者CIAKI发生率。 Short-term statin therapy for prevention of contrast induced-acute kidney injury in patients with diabetes and chronic kidney disease |
| Authors: Y.L. Han1, G.Y. Zhu2, B. Xu3, R. Mehran4, Y. Huo5, 1Shenyang Northern Hospital, Department of Cardiology - Shenyang - China, People's Republic of, 2Asian Heart Hospital - Wuhan - China, People's Republic of, 3Cardiovascular Institute & Fuwai Hospital - Beijing - China, People's Republic of, 4Mount Sinai Medical Center - New York - United States of America, 5No. 1 Hospital affiliated to Beijing Medical University - Beijing - China, People's Republic of, |
| Topic(s): Adjunctive medical therapy |
| Citation: European Heart Journal ( 2013 ) 34 ( Abstract Supplement ), 350 |
Background: Contrast-induced acute kidney injury (CIAKI) is an important complication after contrast media injection. While small studies have shown positive results with statin therapy, the role of statin therapy in prevention of CIAKI remains unknown. The aim of this study was to evaluate the safety and efficacy of rosuvastatinin preventing CIAKI in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). Methods and results: We randomized 2,998 patients with type 2 DM and concomitant CKD who were undergoing coronary/peripheral arterial angiography with or without percutaneous intervention to rosuvastatin 10 mg/day (n=1,498) for five days (two days before, three days post procedure) or standard-of-care (n=1,500). Renal function was assessed at baseline, 48, and 72 hours aftercontrast mediaexposure. The primary endpoint of the study was the development of CIAKI, which was defined as an increase in serum creatinine concentration ≥0.5 mg/dL (44.2μmol/L) or ≥25% above baseline at 72 hours after exposure to contrast media. Patients randomized to the rosuvastatin group had a significantly lower incidence of CIAKI compared to controls (2.3% vs 3.9%;P=0.01; OR=0.58, 95% CI 0.38, 0.89). There was no significant difference in the rate of major adverse cardiac events (MACE) except worsening heart failure, which was significantly lower in patients treated with rosuvastatin (2.6% vs 4.3%;P=0.02). Conclusion: Rosuvastatin significantly reduced the risk of CIAKI in patients with DM and CKD undergoing arterial contrast media injection. |
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#韩雅玲教授#
96
#肾病患者#
68
#慢性肾病患者#
82
#损伤#
68
#韩雅玲#
63