Prevention of Contrast-Induced Nephropathy after Coronary Angiography/PCI with High-Dose Strong Statins in Japanese Patients: The PREVENT CINC-J Study

The PREVENT CINC-J study of Japanese patients receiving statin therapy showed that high-dose strong statin administration increased the incidence of contrast nephropathy in chronic kidney disease patients undergoing coronary angiography/PCI, Dr. Makoto Watanabe et al. of Nara Medical University reported in the August 25 issue of Circulation Journal.

In the PREVENT CINC-J study, from May 2016 to October 2018, 420 patients with chronic kidney disease undergoing coronary angiography enrolled from 18 centers in Japan were randomly assigned to receive high-dose pitavastatin (4 mg/day) for 4 days from the day before surgery to 2 days after surgery in 213 patients (statin group) or no statin group in 207 patients (control group). All patients were scheduled to receive a single bolus dose of isotonic saline and sodium bicarbonate (20 mEq), while the control group continued statin therapy at the same dose as before randomization.

Baseline clinical characteristics were balanced between the two groups, with a mean patient age of 73 years, 74% male, and 46% had diabetes. The mean serum creatinine level was 1.20 mg/dL and eGFR was 46.0 mL/min/1.73 m². Prior to randomization, 83% of patients were on statin therapy.

The rate of contrast nephropathy, defined as a serum creatinine level ≥0.5 mg/dL or ≥25% increase from baseline 48 hours after contrast media use, was higher in the statin group compared to controls (3.0% vs 0%: p=0.01). 12-month MACE (all cause mortality, non-fatal MI, stroke and heart failure hospitalization) rates were similar in both groups.

Dr. Watanabe and colleagues summarize, "High-dose pitavastatin administration increased the incidence of contrast nephropathy in the patient population in this study.

Watanabe M, et al. Circ J. 2022; 86: 1455-1463

※コンテンツには、国内で未承認、適応外の医療機器、医薬品、または効能・効果/用法・用量の情報を含む場合がありますが、未承認、適応外の使用を推奨するものではありません。

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