P4278Efficacy of oxygen preconditioning in preventing contrast induced nephropathy in patients undergoing coronary angiography or percutaneous coronary intervention

Abstract

Purpose: To study the efficacy of oxygen preconditioning in preventing contrast induced nephropathy (CIN) in patients with moderate or high risk of CIN undergoing coronary angiography or percutaneous coronary intervention (PCI). Methods: The study was a randomized controlled study including 80 patients with moderate or high risk of CIN according to Mehran risk score. The study group (40 patients) received nasal oxygen 2 L/min for 10 minutes before and during the procedure while the control group (40 patients) had undergone coronary angiography on room air. Both groups received adequate hydration with 1ml/kg/hr normal saline 12 hours before the procedure and up to 12 hours after the procedure. Both groups received N‐acetylcysteine (NAC) (600 mg twice daily) on the day before and the day of administering contrast media. Serum creatinine was measured prior to the procedure and two days after the procedure. CIN was defined as a proportional rise of 25% in serum creatinine level or an absolute increase in serum creatinine level by 0.5 mg/dL from baseline 48 hours after contrast exposure. Results: There was no statistically significant difference between both groups regarding age (Mean age in the study group was 59.4 and 60.3 in control group) and gender (50% of the study group were males vs 37.5% in the control group). Also there was no statistically significant difference between both groups regarding significant risk factors of CIN according to Mehran risk score as diabetes mellitus (82.5% in study group vs 62.5% in control group), hypertension (40% in study group vs 37.5% in control group), Congestive heart failure (CHF) (70% in study group vs 60% in control group), Chronic kidney disease (CKD) (23.8% in study group vs 22.5% in control group) and anemia (77.5% in study group vs 82.5% in control group). A total of 17 patients out of 80 patients developed CIN representing an overall incidence of CIN in the study population of (21.3%). Twelve patients in the control group developed CIN (30%), while only 5 patients of the study group (12.5%) developed CIN (P value <0.05). Conclusion: Oxygen preconditioning has a statistically significant role in prevention of CIN in patients undergoing coronary angiography or elective percutaneous coronary intervention with moderate and high risk to develop CIN.