Incidence, Dynamics, and Determinants of Acute Kidney Injury following CABG and Postoperative Coronary Angiogram: A Comprehensive Analysis of 242 Patients

Introduction: Recent literature has shown the advantages of postoperative coronary angiogram after postoperative myocardial infarction (PMI) following CABG. However, sparse studies have reported on the effects of contrast agent exposition on renal function postoperatively. The current study aims to evaluate the renal function after coronary angiogram and to identify the risk factors responsible for the onset of contrast induced acute kidney injury (CI-AKI).

Methods: A total of 242 patients, with a mean age of 62 (range: 43–88, 26% female), underwent postoperative coronary angiogram after CABG. Acute kidney injury was defined as a rise in Serum Creatinine (SCr) ≥ 0.5 mg/dL or a 25% increase from baseline value, assessed within 48 hours after the angiogram. A logistic regression analysis was applied in order to identify risk factors for occurrence of CI-AKI.

Results: CI-AKI occurred in 82/242 (33.88%) patients. In the majority of the cases, the creatinine peaked during the 2nd day after the angiogram and then the average creatinine levels went down toward the 5th day. The multivariate analysis showed the following variables to be independent predictors: age (p < 0.02, OR: 1.05), chronic obstructive pulmonary disease (COPD; p < 0.0155, OR: 3.89), interval between surgery and angiogram (p < 0.028, OR: 0.61) and baseline of creatinine prior to angiogram (p < 0.005, OR: 0.05).

Conclusions: One third of patients who undergo angiogram after CABG develop a CI-AKI. The occurrence of CI-AKI must be considered during the decision making prior to coronary angiogram especially in patients deemed at high risk for CI-AKI as identified in this study.

No conflict of interest has been declared by the author(s).