Hyperglycemia is linked to increased risk for CAG contrast-induced nephropathy

  • Kewcharoen J & al.
  • Cardiovasc Revasc Med
  • 4 May 2020

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Preprocedural hyperglycemia (PH) is significantly associated with the risk for contrast-induced nephropathy (CIN) following coronary angiography (CAG), including in patients without diabetes.

Why this matters

  • Previous studies on this relationship have been underpowered.

Study design

  • Meta-analysis of 8 studies from the United States, Europe, and Asia, including 10,991 patients undergoing CAG.
  • Funding: None.

Key results

  • Overall, PH was significantly associated with increased CIN risk (pooled ORs) when PH was defined as:
    • ≥140 mg/dL: 1.71 (P<.001 or>
    • ≥200 mg/dL: 2.07 (P<.001>
  • In a subgroup analysis of patients admitted with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), PH was significantly associated with CIN risk, with PH defined as ≥200 mg/dL:
    • Pooled OR: 2.56 (P<.001>
  • In subgroup of patients without diabetes admitted with STEMI and undergoing PCI, PH was associated with increased CIN risk (pooled ORs), with PH defined as:
    • ≥140 mg/dL: 1.76 (P<.001 or>
    • ≥200 mg/dL: 2.83 (P<.001>

Limitations

  • Causal relationship unproven.
  • Insufficient data for subgroup analysis on populations with diabetes or without baseline chronic kidney disease.  
  • Potential confounding.