Short-term Rosuvastatin Treatment for the Prevention of Contrast-induced Acute Kidney Injury in Patients Receiving Moderate or High Volumes of Contrast Media： A Sub-analysis of the TRACK-D Study

• Published in: Chinese medical journal Vol. 128; no. 6; pp. 784 - 789
• Main Authors: Zhang, Jian, Li, Yi, Tao, Gui-Zhou, Chen, Yun-Dai, Hu, Tao-Hong, Cao, Xue-Bin, Jing, Quan-Min, Wang, Xiao-Zeng, Ma, Ying-Yan, Wang, Geng, Liu, Hai-Wei, Wang, Bin, Xu, Kai, Li, Jing, Deng, Jie, Han, Ya-Ling
• Format: Journal Article
• Language: English
• Published: China Medknow Publications Pvt Ltd 20.03.2015; Medknow Publications and Media Pvt. Ltd; Lippincott Williams & Wilkins Ovid Technologies; Department of Cardiology, General Hospital of Shenyang Military Region, Shenyang, Liaoning 110840, China%Department of Cardiology, First Hospital of Liaoning Medical College, Jinzhou, Liaoning 110840, China%Department of Cardiology, General Hospital of People's Liberation Army, Beijing 100853, China%Department of Cardiology, The Second Artillery General Hospital of People's Liberation Army, Beijing 100088, China%Department of Cardiology, No.252 Hospital of People's Liberation Army, Baoding, Hebei 071000, China; Medknow Publications & Media Pvt Ltd; Wolters Kluwer
• Subjects: Acute; Acute Kidney Injury - chemically induced; Acute Kidney Injury - prevention & control; Aged; Analysis; Angiography; Cardiology; Care and treatment; Chronic; Chronic Kidney Disease; Contrast-induced Acute Kidney Injury; Rosuvastatin; Chronic kidney failure; Contrast Media - adverse effects; Contrast-induced; Diabetes; Disease; Dosage and administration; Female; Fluorobenzenes - therapeutic use; Heart failure; Humans; Injury; Kidney; Kidneys; Male; Middle Aged; Original; Pyrimidines - therapeutic use; Rosuvastatin; Rosuvastatin Calcium; Short term; Statins; Sulfonamides - therapeutic use; Task forces; Thoracic surgery; Treatment Outcome; China; Contrast-induced Acute Kidney Injury; Chronic Kidney Disease; Rosuvastatin
• ISSN: 0366-6999; 2542-5641
• DOI: 10.4103/0366-6999.152620

Background： Current randomized trials have demonstrated the effects of short-term rosuvastatin therapy in preventing contrast-induced acute kidney injury （CIAK1）. 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.