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OP-233 DOES NEBIVOLOL PREVENT CONTRAST-INDUCED NEPHROPATHY IN HUMANS?
S60
Oral Presentations / International Journal of Cardiology 155S1 (2012) S1–S89
underwent MDCT for evaluation of CAD and stent patency between 2006 and 2009. Coronary imaging was performed via dual source MDCT scanner (Somatom Definition; Siemens, Erlangen, Germany). Stented vessel segment was evaluated as patent without neointimal hyperplasia (NIH), nonobstructive NIH (<50% luminal narrowing) or obstructive NIH (>50% luminal narrowing). Patients were evaluated for major cardiovascular events (MACE) to demonstrate association between stent patency and clinical outcome. MACE that were originating from non-stented segments were excluded. Results: A total of 213 coronary stents were evaluated in our study. During mean 21.2 months follow-up, 25 patients experienced MACE [1 (4.0%) cardiac death, 5 (20.0%) nonfatal MI, 19 (76.0%) unstable angina pectoris requiring hospitalization and target vessel revascularization] associated with stented segment of coronary arteries. 100 patients (95.2% of 105) with patent stent without NIH detected by MDCT had no cardiac event associated with stented segments during mean 1.5 years follow-up period. Conclusions: Our results indicate that, patients who had patent stent without NIH on MDCT had a good prognosis, whereas an increased event rate was observed in patients with nonobstructive or obstructive NIH on MDCT. Table: Clinical outcomes of the study population
No events (n, %) Death (n, %) Non-fatal MI (n, %) USAP and TVR (n, %)
Patients without obstructive NIH (no or non-obstructive)
Patients with obstructive NIH
P value
113 (91.9%) 0 (0.0%) 2 (1.6%) 8 (6.5%)
12 (44.4%) 1 (3.7%) 3 (11.1%) 11 (40.7%)
<0.05 <0.05 <0.05 <0.05
TVR, target vessel revascularization; USAP, unstable angina pectoris.
OP-232 ROSUVASTATIN VERSUS ATORVASTATIN IN PREVENTING CONTRAST INDUCED NEPHROPATHY AMONG PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION (ROSA-CIN TRIAL) A. Kaya1 , M. Kurt1 , I.H. Tanboga1 , T. Isik1 , M. Ekinci1 , E. Aksakal2 , S. Sevimli2 . 1 Erzurum Educarion and Research Hospital, Erzurum, Turkey; 2 Department of Cardiology, Ataturk University, Erzurum, Turkey Objective: Contrast induced nephropathy (CIN) has been associated with increased morbidity, extended hospital stay and increased costs. Currently, there is limited evidence supporting that a definite treatment may be useful as a standard prophylactic procedure. We aimed to compare atorvastatin and rosuvastatin in ST elevated myocardial infarction (STEMI) patients undergoing primary coronary angioplasty (pPCI). Methods: The study population consisted of 192 STEMI patients who underwent pPCI. Prior to the pPCI, the study population was split into two categories in a randomized fashion as atorvastatin 80 mg (n = 98) and rosuvastatin 40 mg (n = 94). At 48 hours, blood samples were obtained from the patients for the evaluation of serum creatinine value. Results: There was no difference between the statin groups with regard to baseline demographic and clinical characteristics. None of the renal dysfunction markers (baseline creatinine, baseline eGFR, creatinine at 48h, eGFR at 48h, difference between baseline and 48-hour creatinine, and percentage change of creatinine at 48 hours with respect to baseline) revealed a statistically significant difference in between statin groups. Multivariate logistic regression analysis was performed to determine the CIN predictors. Only contrast amount was observed to be an independent predictor for CIN in STEMI patients that underwent pPCI (OR, 1.08; 95% CI, 1.03–1.13; p = 0.002). LV-EF demonstrated a borderline statistical significance (OR, 0.88; 95% CI, 0.77–1.01; p = 0.073). Conclusions: Our study shows that rosuvastatin is not superior to atorvastatin in terms of prevention of contrast induced nephropathy in patients with STEMI.
OP-233 DOES NEBIVOLOL PREVENT CONTRAST-INDUCED NEPHROPATHY IN HUMANS? O. Gunebakmaz1 , M.G. Kaya1 , F. Koc2 , M. Akpek1 , A. Kasapkara1 , M.T. Inanc1 , M. Yarlioglues1 , B. Calapkorur1 , Z. Karadag1 , A. Oguzhan1 . 1 Department of Cardiology, Erciyes University School of Medicine; 2 Department of Cardiology, Gaziosmanpasa University, School of Medicine Objective: An experimental study showed that nebivolol is an affective agent in contrast-induced nephropathy (CIN) prophylaxis. We attempted to demonstrate the effect of prophylactic nebivolol use on renal function in human beings subjected to iodinated contrast agent. Methods: 120 patients scheduled for coronary angiography and ventriculography were enrolled into present study. All patients were hydrated with intravenous isotonic saline. The patients in Group I received 600 mg NAC every 12 hours for 4 days. The patients in Group II received 5 mg nebivolol every 24 hours for 4 days. The patients in Group III were only hydrated. The primary end point was the occurrence of CIN. The secondary end point was the change in SCr levels at 2-day and 5-day after the contrast exposure. Results: Baseline demographic, clinical characteristics and medications were similar among the randomized groups, with no significant differences. There was also no significant difference with regard to Mehran risk score that predicts CIN risk (Table 1). We called NAC plus 0.9% saline group as Group I, nebivolol plus 0.9% saline group as Group II and 0.9% saline group as Group III.CIN occurred in 9 patients (22.5%) in Group I, 8 patients (20%) in Group II and 11 patiens (27.5%) in Group III (p = 0.72). Changes in mean creatinine level from baseline to 2-day were not statistically signifigant in all groups. However, we detected statistically signifigant increase in mean creatinine levels at 5-day compared to baseline levels in Group I and Group III (from1.42±0.13 to 1.52±0.26, p2=0.02; from1.43±0.14 to 1.55±0.30, p2=0.01, respectively) (Figure 1). Although an increase was detected in mean creatinine level from baseline to 5-day creatinine level in Group II, this did not reach statistically signifigant point (from 1.40±0.12 to 1.48±0.23, p = 0.06) (Figure 1). Conclusions: Pre-treatment with nebivolol is protective against nephrotoxic effects of contrast media.
Figure 1. Change in serum creatinine levels over time in every group, showing only Nebivolol plus 0.9% saline group had nonsignificant increase in serum creatinine at 5-day compared to basal level.
Oral Presentations / International Journal of Cardiology 155S1 (2012) S1–S89
Table 1. Baseline parameters
Table 1. Baseline patient characteristics Baseline characteristics Age (y) Sex (male/female) Weight (kg) BMI (kg/m2 LVEF (%) Diabetes mellitus [n (%)] Hypertension [n (%)] Current smoker [n (%)] Baseline creatinine Baseline CrCl (mL/min) Total cholesterol (mg/dl) LDL cholesterol (mg/dl) Contrast agent dose (mL) Contrast agent dose/BMI (mL/BMI) Mehran risk score Medications ACEI [n (%)] ARB [n (%)] Thiazide [n (%)] Statin [n (%)]
S61
NAC plus 0.9% saline (Group I) (n = 40)
Nebivolol plus 0.9% saline (Group II) (n = 40)
0.9% saline (Group III) (n = 40)
p
64.7±11.9 29/11 74.5±12.4 27.7±4.7 50.0 12 (30) 26 (65) 15 (37.5) 1.42±0.13 49.8 168.5 108.1 63.4 2.34 5.7±2.7
64.1±9.0 29/11 71.9±12.9 26.4±4.2 51.5 14 (35) 31 (77.5) 19 (47.5) 1.40±0.12 51.6 177.6 112.6 61.8 2.38 5.5±2.5
66.4±10.7 25/15 76.1±10.7 27.8±3.7 49.2 11 (27.5) 26 (65) 13 (32.5) 1.43±0.14 47.6 186.3 116.5 64.2 2.33 6.5±3.1
0.59 0.53 0.28 0.29 0.34 0.76 0.37 0.37 0.58 0.08 0.21 0.61 0.83 0.93 0.23
21 (52.5) 2 (5) 7 (17.5) 15 (37.5)
29 (72.5) 2 (5) 9 (22.5) 15 (37.5)
29 (72.5) 2 (5) 9 (22.5) 22 (55)
0.09 1.0 0.81 0.19
Data are presented as the mean value±S.D. or number or percentage of patients. p < 0.05 considered statistically significant. NAC, N-acetylcysteine; BMI, body mass index; LVEF, left ventricular ejection fraction; CrCl, creatinine clearance; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker.
OP-234 CONTRAST-INDUCED NEPHROPATHY IN AD HOC VERSUS NON-AD HOC PERCUTANEOUS CORONARY INTERVENTIONS 1 H. Ari1 , S. Cosar1 , K. Doganay1 , N. Celiloglu1 , S. Cetinkaya ¸ , 2 ¨ N. Emlek1 , H. Ozkan , T. Bozat1 . 1 Bursa Yuksek Ihtisas Eg. ve Aras. Hast., Kardiyoloji Bolumu, Bursa, Turkey; 2 Bursa Medikal Park Hastanesi, Kardiyoloji Bolumu, Bursa, Turkey Objective: Ad hoc percutaneous coronary intervention (PCI), whereby PCI is performed immediately after cardiac catheterization, has become the common way of performing PCI. However, no studies have evaluated contrast-induced nephropthy (CIN) rate for ad hoc and non-ad hoc PCIs. Our aim was to compare CIN rate for ad hoc PCI and non-ad hoc PCI. Methods: A total of 2604 patients who underwent coronary angiography or PCI in Bursa Postgraduate Hospital were prospectively evaluate in terms of CIN. We entered the study 382 patients; 108 had ad hoc PCI and 274 had non-ad hoc PCI. We evaluate the patients demographic and angiographic characteristics, GFR and creatinin levels before PCI. We check creatinin levels 48–72h after PCI in terms of CIN. GFR calculate according to Cocraft-Gault Formula. The definition of CIN includes absolute (≥0.5 mg/dl) or relative increase (≥25%) in serum creatinine at 48–72h after exposure to a contrast agent compared to baseline serum creatinine values. We used omnipaque 350 mg I/ml (iohexol) for all procedures. The patients with chronic renal failure were excluded.
Figure 1. CIN rate. CIN: contrast-induced nephropathy, PCI: percutaneous coronary intervention.
Age (year) Gender n, (%) Male Female BMI (kg/m2 ) LV EF (%) Hypertension; n (%) Diabetes Mellitus; n (%) GFR (ml/min) Baseline Urea (mg/dl) Baseline Creatinin (mg/dl) Contrast Volume (ml) Medication ACEI; n (%) ARB; n (%) Statin; n (%) Diuretic; n (%) Sulfonylurea; n (%) Insulin; n (%) Number of Vessel (>%50 lesion); n (%) 1 vessel 2 vessel 3 vessel
Ad Hoc PCI, N = 108
Non-Ad Hoc PCI, N = 274
P value
59.94±11.75
59.52±10.78
0.73 0.57
77 (71) 31 (28.7) 29.46±14.49 52.17±9.69 56 (51.9) 19 (17.6) 100.91±37.05 36.39±18.24 0.98±0.52
203 (74) 71 (25.9) 27.66±4.28 52.44±9.81 138 (50.4) 55 (20.1) 98.57±32.31 31.96±13.52 0.93±0.23
0.06 0.81 0.79 0.58 0.54 0.01 0.19
161.43±77.98
150.91±90.12
0.28
45 (41.6) 18 (16.7) 29 (26.3) 5 (4.6) 8 (7.4) 4 (3.7)
127 (46.4) 48 (17.5) 91 (33.2) 9 (3.3) 22 (8) 16 (5.8)
0.31 0.84 0.22 0.52 0.83 0.39
76 (70.4) 26 (24.1) 6 (5.6)
203 (74.1) 64 (23.4) 7 (2.6)
0.33
Results: The CIN rate in ad hoc PCI group 17.6% (19 of 108 patients) versus in non-ad hoc PCI group 11.3% (31 of 274 patients); p = 0.10 (figure 1). Baseline parameters were similar in both groups, except urea levels; urea value was significantly higher in ad hoc group than non-ad hoc group (p = 0.01) (Table 1). Conclusions: There was no difference in CIN rate; between ad hoc PCI and non-ad hoc PCI in patients with elective PCI. Friday, 2 March 2012
15:30–17:00
Mastering in Surgical Myocardial Revascularization OP-235 THE EFFECT OF THE PREOPERATIVE USE OF ANGIOTENSIN CONVERTING ENZYME in HIBITOR ON CARDIOPULMONARY BYPASS AND THE RENAL FUNCTIONS AFTER CORONARY ARTERY BYPASS 1 1 ¨ ¨ ¨ M.E. Oner , S. ¸ Yavuz1 , E. Ozbudak , O. Baris2 , M. Kanko1 , K.T. Berki1 . 1 Department of Cardiovascular Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey; 2 Sakarya Training Hospital, Sakarya, Turkey Objective: The purpose of this study is to search the postoperative effects of the preoperative use of angiotensin converting enzyme inhibitors on renal functions in patients undergoing cardiopulmonary bypass and coronary artery bypass surgery. Methods: 139 patients (110 male, 29 female) who underwent isolated coronary artery bypass in our clinic were enrolled to the study. The patients were separated into two groups as the patients who hadn’t used angiotensin converting enzyme preoperatively (group 1) and the ones who had used it (group 2). Collection of data was according to the creatinine levels. Data were collected and recorded preoperatively and on the 0, 1st, 2nd, 4th and 7th day postoperatively. Results: There was no statistically significant difference between the two groups in terms of creatinine levels (p > 0.05). When the mean levels were considered, in the group that hadn’t used angiotensin converting enzyme inhibitor, compared to the preoperative levels (0.92±0.02), the creatinine levels were increased on the postoperative 0 (0.96±0.03), postoperative 1st (1.11±0.04) and postoperative 2nd (1.12±0.05) days and
Oral Presentations / International Journal of Cardiology 155S1 (2012) S1–S89
underwent MDCT for evaluation of CAD and stent patency between 2006 and 2009. Coronary imaging was performed via dual source MDCT scanner (Somatom Definition; Siemens, Erlangen, Germany). Stented vessel segment was evaluated as patent without neointimal hyperplasia (NIH), nonobstructive NIH (<50% luminal narrowing) or obstructive NIH (>50% luminal narrowing). Patients were evaluated for major cardiovascular events (MACE) to demonstrate association between stent patency and clinical outcome. MACE that were originating from non-stented segments were excluded. Results: A total of 213 coronary stents were evaluated in our study. During mean 21.2 months follow-up, 25 patients experienced MACE [1 (4.0%) cardiac death, 5 (20.0%) nonfatal MI, 19 (76.0%) unstable angina pectoris requiring hospitalization and target vessel revascularization] associated with stented segment of coronary arteries. 100 patients (95.2% of 105) with patent stent without NIH detected by MDCT had no cardiac event associated with stented segments during mean 1.5 years follow-up period. Conclusions: Our results indicate that, patients who had patent stent without NIH on MDCT had a good prognosis, whereas an increased event rate was observed in patients with nonobstructive or obstructive NIH on MDCT. Table: Clinical outcomes of the study population
No events (n, %) Death (n, %) Non-fatal MI (n, %) USAP and TVR (n, %)
Patients without obstructive NIH (no or non-obstructive)
Patients with obstructive NIH
P value
113 (91.9%) 0 (0.0%) 2 (1.6%) 8 (6.5%)
12 (44.4%) 1 (3.7%) 3 (11.1%) 11 (40.7%)
<0.05 <0.05 <0.05 <0.05
TVR, target vessel revascularization; USAP, unstable angina pectoris.
OP-232 ROSUVASTATIN VERSUS ATORVASTATIN IN PREVENTING CONTRAST INDUCED NEPHROPATHY AMONG PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION (ROSA-CIN TRIAL) A. Kaya1 , M. Kurt1 , I.H. Tanboga1 , T. Isik1 , M. Ekinci1 , E. Aksakal2 , S. Sevimli2 . 1 Erzurum Educarion and Research Hospital, Erzurum, Turkey; 2 Department of Cardiology, Ataturk University, Erzurum, Turkey Objective: Contrast induced nephropathy (CIN) has been associated with increased morbidity, extended hospital stay and increased costs. Currently, there is limited evidence supporting that a definite treatment may be useful as a standard prophylactic procedure. We aimed to compare atorvastatin and rosuvastatin in ST elevated myocardial infarction (STEMI) patients undergoing primary coronary angioplasty (pPCI). Methods: The study population consisted of 192 STEMI patients who underwent pPCI. Prior to the pPCI, the study population was split into two categories in a randomized fashion as atorvastatin 80 mg (n = 98) and rosuvastatin 40 mg (n = 94). At 48 hours, blood samples were obtained from the patients for the evaluation of serum creatinine value. Results: There was no difference between the statin groups with regard to baseline demographic and clinical characteristics. None of the renal dysfunction markers (baseline creatinine, baseline eGFR, creatinine at 48h, eGFR at 48h, difference between baseline and 48-hour creatinine, and percentage change of creatinine at 48 hours with respect to baseline) revealed a statistically significant difference in between statin groups. Multivariate logistic regression analysis was performed to determine the CIN predictors. Only contrast amount was observed to be an independent predictor for CIN in STEMI patients that underwent pPCI (OR, 1.08; 95% CI, 1.03–1.13; p = 0.002). LV-EF demonstrated a borderline statistical significance (OR, 0.88; 95% CI, 0.77–1.01; p = 0.073). Conclusions: Our study shows that rosuvastatin is not superior to atorvastatin in terms of prevention of contrast induced nephropathy in patients with STEMI.
OP-233 DOES NEBIVOLOL PREVENT CONTRAST-INDUCED NEPHROPATHY IN HUMANS? O. Gunebakmaz1 , M.G. Kaya1 , F. Koc2 , M. Akpek1 , A. Kasapkara1 , M.T. Inanc1 , M. Yarlioglues1 , B. Calapkorur1 , Z. Karadag1 , A. Oguzhan1 . 1 Department of Cardiology, Erciyes University School of Medicine; 2 Department of Cardiology, Gaziosmanpasa University, School of Medicine Objective: An experimental study showed that nebivolol is an affective agent in contrast-induced nephropathy (CIN) prophylaxis. We attempted to demonstrate the effect of prophylactic nebivolol use on renal function in human beings subjected to iodinated contrast agent. Methods: 120 patients scheduled for coronary angiography and ventriculography were enrolled into present study. All patients were hydrated with intravenous isotonic saline. The patients in Group I received 600 mg NAC every 12 hours for 4 days. The patients in Group II received 5 mg nebivolol every 24 hours for 4 days. The patients in Group III were only hydrated. The primary end point was the occurrence of CIN. The secondary end point was the change in SCr levels at 2-day and 5-day after the contrast exposure. Results: Baseline demographic, clinical characteristics and medications were similar among the randomized groups, with no significant differences. There was also no significant difference with regard to Mehran risk score that predicts CIN risk (Table 1). We called NAC plus 0.9% saline group as Group I, nebivolol plus 0.9% saline group as Group II and 0.9% saline group as Group III.CIN occurred in 9 patients (22.5%) in Group I, 8 patients (20%) in Group II and 11 patiens (27.5%) in Group III (p = 0.72). Changes in mean creatinine level from baseline to 2-day were not statistically signifigant in all groups. However, we detected statistically signifigant increase in mean creatinine levels at 5-day compared to baseline levels in Group I and Group III (from1.42±0.13 to 1.52±0.26, p2=0.02; from1.43±0.14 to 1.55±0.30, p2=0.01, respectively) (Figure 1). Although an increase was detected in mean creatinine level from baseline to 5-day creatinine level in Group II, this did not reach statistically signifigant point (from 1.40±0.12 to 1.48±0.23, p = 0.06) (Figure 1). Conclusions: Pre-treatment with nebivolol is protective against nephrotoxic effects of contrast media.
Figure 1. Change in serum creatinine levels over time in every group, showing only Nebivolol plus 0.9% saline group had nonsignificant increase in serum creatinine at 5-day compared to basal level.
Oral Presentations / International Journal of Cardiology 155S1 (2012) S1–S89
Table 1. Baseline parameters
Table 1. Baseline patient characteristics Baseline characteristics Age (y) Sex (male/female) Weight (kg) BMI (kg/m2 LVEF (%) Diabetes mellitus [n (%)] Hypertension [n (%)] Current smoker [n (%)] Baseline creatinine Baseline CrCl (mL/min) Total cholesterol (mg/dl) LDL cholesterol (mg/dl) Contrast agent dose (mL) Contrast agent dose/BMI (mL/BMI) Mehran risk score Medications ACEI [n (%)] ARB [n (%)] Thiazide [n (%)] Statin [n (%)]
S61
NAC plus 0.9% saline (Group I) (n = 40)
Nebivolol plus 0.9% saline (Group II) (n = 40)
0.9% saline (Group III) (n = 40)
p
64.7±11.9 29/11 74.5±12.4 27.7±4.7 50.0 12 (30) 26 (65) 15 (37.5) 1.42±0.13 49.8 168.5 108.1 63.4 2.34 5.7±2.7
64.1±9.0 29/11 71.9±12.9 26.4±4.2 51.5 14 (35) 31 (77.5) 19 (47.5) 1.40±0.12 51.6 177.6 112.6 61.8 2.38 5.5±2.5
66.4±10.7 25/15 76.1±10.7 27.8±3.7 49.2 11 (27.5) 26 (65) 13 (32.5) 1.43±0.14 47.6 186.3 116.5 64.2 2.33 6.5±3.1
0.59 0.53 0.28 0.29 0.34 0.76 0.37 0.37 0.58 0.08 0.21 0.61 0.83 0.93 0.23
21 (52.5) 2 (5) 7 (17.5) 15 (37.5)
29 (72.5) 2 (5) 9 (22.5) 15 (37.5)
29 (72.5) 2 (5) 9 (22.5) 22 (55)
0.09 1.0 0.81 0.19
Data are presented as the mean value±S.D. or number or percentage of patients. p < 0.05 considered statistically significant. NAC, N-acetylcysteine; BMI, body mass index; LVEF, left ventricular ejection fraction; CrCl, creatinine clearance; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker.
OP-234 CONTRAST-INDUCED NEPHROPATHY IN AD HOC VERSUS NON-AD HOC PERCUTANEOUS CORONARY INTERVENTIONS 1 H. Ari1 , S. Cosar1 , K. Doganay1 , N. Celiloglu1 , S. Cetinkaya ¸ , 2 ¨ N. Emlek1 , H. Ozkan , T. Bozat1 . 1 Bursa Yuksek Ihtisas Eg. ve Aras. Hast., Kardiyoloji Bolumu, Bursa, Turkey; 2 Bursa Medikal Park Hastanesi, Kardiyoloji Bolumu, Bursa, Turkey Objective: Ad hoc percutaneous coronary intervention (PCI), whereby PCI is performed immediately after cardiac catheterization, has become the common way of performing PCI. However, no studies have evaluated contrast-induced nephropthy (CIN) rate for ad hoc and non-ad hoc PCIs. Our aim was to compare CIN rate for ad hoc PCI and non-ad hoc PCI. Methods: A total of 2604 patients who underwent coronary angiography or PCI in Bursa Postgraduate Hospital were prospectively evaluate in terms of CIN. We entered the study 382 patients; 108 had ad hoc PCI and 274 had non-ad hoc PCI. We evaluate the patients demographic and angiographic characteristics, GFR and creatinin levels before PCI. We check creatinin levels 48–72h after PCI in terms of CIN. GFR calculate according to Cocraft-Gault Formula. The definition of CIN includes absolute (≥0.5 mg/dl) or relative increase (≥25%) in serum creatinine at 48–72h after exposure to a contrast agent compared to baseline serum creatinine values. We used omnipaque 350 mg I/ml (iohexol) for all procedures. The patients with chronic renal failure were excluded.
Figure 1. CIN rate. CIN: contrast-induced nephropathy, PCI: percutaneous coronary intervention.
Age (year) Gender n, (%) Male Female BMI (kg/m2 ) LV EF (%) Hypertension; n (%) Diabetes Mellitus; n (%) GFR (ml/min) Baseline Urea (mg/dl) Baseline Creatinin (mg/dl) Contrast Volume (ml) Medication ACEI; n (%) ARB; n (%) Statin; n (%) Diuretic; n (%) Sulfonylurea; n (%) Insulin; n (%) Number of Vessel (>%50 lesion); n (%) 1 vessel 2 vessel 3 vessel
Ad Hoc PCI, N = 108
Non-Ad Hoc PCI, N = 274
P value
59.94±11.75
59.52±10.78
0.73 0.57
77 (71) 31 (28.7) 29.46±14.49 52.17±9.69 56 (51.9) 19 (17.6) 100.91±37.05 36.39±18.24 0.98±0.52
203 (74) 71 (25.9) 27.66±4.28 52.44±9.81 138 (50.4) 55 (20.1) 98.57±32.31 31.96±13.52 0.93±0.23
0.06 0.81 0.79 0.58 0.54 0.01 0.19
161.43±77.98
150.91±90.12
0.28
45 (41.6) 18 (16.7) 29 (26.3) 5 (4.6) 8 (7.4) 4 (3.7)
127 (46.4) 48 (17.5) 91 (33.2) 9 (3.3) 22 (8) 16 (5.8)
0.31 0.84 0.22 0.52 0.83 0.39
76 (70.4) 26 (24.1) 6 (5.6)
203 (74.1) 64 (23.4) 7 (2.6)
0.33
Results: The CIN rate in ad hoc PCI group 17.6% (19 of 108 patients) versus in non-ad hoc PCI group 11.3% (31 of 274 patients); p = 0.10 (figure 1). Baseline parameters were similar in both groups, except urea levels; urea value was significantly higher in ad hoc group than non-ad hoc group (p = 0.01) (Table 1). Conclusions: There was no difference in CIN rate; between ad hoc PCI and non-ad hoc PCI in patients with elective PCI. Friday, 2 March 2012
15:30–17:00
Mastering in Surgical Myocardial Revascularization OP-235 THE EFFECT OF THE PREOPERATIVE USE OF ANGIOTENSIN CONVERTING ENZYME in HIBITOR ON CARDIOPULMONARY BYPASS AND THE RENAL FUNCTIONS AFTER CORONARY ARTERY BYPASS 1 1 ¨ ¨ ¨ M.E. Oner , S. ¸ Yavuz1 , E. Ozbudak , O. Baris2 , M. Kanko1 , K.T. Berki1 . 1 Department of Cardiovascular Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey; 2 Sakarya Training Hospital, Sakarya, Turkey Objective: The purpose of this study is to search the postoperative effects of the preoperative use of angiotensin converting enzyme inhibitors on renal functions in patients undergoing cardiopulmonary bypass and coronary artery bypass surgery. Methods: 139 patients (110 male, 29 female) who underwent isolated coronary artery bypass in our clinic were enrolled to the study. The patients were separated into two groups as the patients who hadn’t used angiotensin converting enzyme preoperatively (group 1) and the ones who had used it (group 2). Collection of data was according to the creatinine levels. Data were collected and recorded preoperatively and on the 0, 1st, 2nd, 4th and 7th day postoperatively. Results: There was no statistically significant difference between the two groups in terms of creatinine levels (p > 0.05). When the mean levels were considered, in the group that hadn’t used angiotensin converting enzyme inhibitor, compared to the preoperative levels (0.92±0.02), the creatinine levels were increased on the postoperative 0 (0.96±0.03), postoperative 1st (1.11±0.04) and postoperative 2nd (1.12±0.05) days and