长期服用ACEI/ARB对老年病人经冠脉介入术后肾功能的影响研究

doi:10.3969/j.issn.1003-9198.2022.12.013

Abstract

Abstract: Objective To observe the effects of long-term use of angiotensin-converting enzyme inhibitor (ACEI) or angiontensin receptor blocker(ARB) on the renal function in the elderly patients receiving percutaneous coronary intervention (PCI). Methods A total of 112 elderly patients with normal or mild abnormal renal function who underwent PCI were divided into observation group (using ACEI or ARB, n=58) and control group (not using ACEI or ARB, n=54). The serum level of creatinine(CRE) and glomerular filtration rate(eGFR) before or 24, 48 hours after PCI were detected and compared between the two groups. Results The level of CRE was significantly higher and the level of eGFR was significantly lower in both groups 24, 48 hours after PCI than that before PCI, especially in observation group (P<0.05). One patient(1.85%) presented with contrast-induced nephropathy (CIN) in control group. There was no statistical difference in the incidence rate of CIN between two goups (P=0.482). Conclusions In the elderly patients undergoing coronary intervention,long-term use of ACEI or ARB would reduce the effect of contrast medium on the renal function,but does not show a significant adverse effect on the incidence of CIN.

Key words: angiotensin-converting enzyme inhibitor, angiontensin receptor blocker, renal function, percutaneous coronary intervention, aged

CLC Number:

R541.4

ZHU Jing-dong, XU Yu, CHEN Qun, WANG Li-qun. Effect of long-term use of ACEI/ARB on the renal function in elderly patients receiving percutaneous coronary intervention[J]. Practical Geriatrics, 2022, 36(12): 1238-1241.

References

[1] 中华医学会放射学分会对比剂安全使用工作组.碘对比剂使用指南(第2版) [J].中华放射学杂志,2013, 47(10):869-872.
[2] RIHAL C S, TEXTOR S C, GRILL D E, et al.Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention [J]. Circulation,2002,105(19):2259-2264.
[3] MCCULLOUGH P A,WOLYN R, ROCHER L L, et al. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality[J]. Am J Med, 1997, 103(5):368-375.
[4] LEVY E M, VISCOLI C M, HORWITZ R I. The effect of acute renal failure on mortality.A cohort analysis[J]. JAMA, 1996, 275(19):1489-1494.
[5] HOOGWERF B J, YOUNG J B. The HOPE study Ramipril lowered cardiovascular risk, but vitamin E did not [J]. Cleve Clin J Med, 2000, 67(4):287-293.
[6] PERSSON P B, HANSELL P, LISS P. Pathophysiology of contrast mediuminduced nephropathy [J]. Kidney Int, 2005, 68(1):14-22.
[7] CHEN Y T, CHAN C K, LI W Y, et al. Renin-angiotensin-aldosterone system inhibition decreased contrast-associated acute kidney injury in chronic kidney disease patients[J]. J Formos Med Assoc, 2021, 120(1):641-650.
[8] JO S H, LEE J M, PARK J, et al. The impact of renin-angiotensin-aldosterone system blockade on contrast-induced nephropathy: A meta-analysis of 12 studies with 4, 493 patients [J]. Cardiology, 2015, 130(1):4-14.
[9] MCCULLOUGH P A,CHOI J P,FEGHALI G A,et al. Mehta A: Contrast-induced acute kidney injury[J]. J Am Coll Cardiol, 2016,68(13): 1465-1473.
[10] LAZAROS G, ZOGRAFOS T, OIKONOMOU E, et al. Usefulness of C-reactive protein as a predictor of contrast-induced nephropathy after percutaneous coronary interventions in patients with acute myocardial infarction and presentation of a new risk score (Athens CIN score)[J]. Am J Cardiol, 2016, 118(9):1329-1333.
[11] GEENEN R W, KINGMA H J, MOLEN A J V D. Contrast-induced nephropathy: pharmacology, pathophysiology and prevention[J]. Insights Imaging, 2013, 4(6):811-820.
[12] 宋志霞,王俭勤,王静,等. AECI与ARB联合使用对慢性肾功能不全病人残余肾功能保护的研究[J]. 甘肃医药,2010,29(1):83-85.
[13] 罗富里,蔡得汉,杨林,等. 血管紧张素转换酶抑制剂／血管紧张素Ⅱ受体拮抗剂与维持性腹膜透析患者心肾获益的Meta分析[J].肾脏病与透析肾移植杂志,2014,23(3):240-246.
[14] 何新霞,韩卫红,薛燕,等. 血管紧张素转换酶抑制剂和血管紧张素受体拮抗剂对糖尿病肾病患者肾功能的保护作用[J].中国慢性病预防与控制,2007,15(1):34-35.
[15] TOPRAK O, CIRIT M, BAYATA S, et al. The effect of pre-procedural captopril on contrast-induced nephropathy in patients who underwent coronary angiography[J]. Anadolu Kardiyol Derg, 2003, 3(2):104-106.
[16] CIRIT M, TOPRAK O, YESIL M, et al. Angiotensin-converting enzyme inhibitors as a risk factor for contrast-induced nephropathy[J]. Nephron Clin Pract, 2006, 104(1):C20-C27.
[17] MIN Y R,HAN R,WOONG C K,et al. The effect of renin-angiotensin-aldosterone system blockade on contrast-induced acute kidney injury: a propensity-matched study[J]. Am J Kidney Dis, 2012, 60(4):576-582.
[18] ROSENSTOCK J L, BRUNO R, KIM J K, et al. The effect of withdrawal of ACE inhibitors or angiotensin receptor blockers prior to coronary angiography on the incidence of contrast-induced nephropathy[J]. Int Urol Nephrol, 2008, 40(3):749-755.
[19] WU Z J, ZHANG H, JIN W, et al. The effect of renin-angiotensin-aldosterone system blockade medications on contrast-induced nephropathy in patients undergoing coronary angiography: A Meta-analysis[J]. PLoS One, 2015, 10(6): e0129747.
[20] 韩若冰,项荣武,雷添淇,等. ACEI/ARB对造影剂肾病影响程度的Meta分析[J].沈阳药科大学学报,2017,34(8):701-709.

Effect of long-term use of ACEI/ARB on the renal function in elderly patients receiving percutaneous coronary intervention

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Recommended 10

[1]	LI Jiang, QIU Yan, WANG Ting, WANG Dan, YU Yifan, PU Lingli, BU Ling. Correlation between preoperative SII/ALB and clinicopathologic features in elderly patients with lung adenocarcinoma [J]. Practical Geriatrics, 2024, 38(9): 893-896.
[2]	DAI Jing, CUI Yan. Correlation between glycosylated hemoglobin variability and cognitive dysfunction in elderly patients with type 2 diabetes mellitus [J]. Practical Geriatrics, 2024, 38(9): 931-935.
[3]	ZHENG Hong, QI Zhenbo, XU Peng, XU Jie, YU Xinyu, ZANG Yanan, ZHANG Zhaoyan. Effects of hypnotics on cognition function and daytime sleepiness in the elderly [J]. Practical Geriatrics, 2024, 38(9): 936-939.
[4]	ZHANG Xingxing, ZHANG Haiyang, HE Xiaojing, LU Xiang. Investigation on the relationship between different physical indexes and the risk of diabetes mellitus in the elderly [J]. Practical Geriatrics, 2024, 38(9): 940-943.
[5]	NI Hongyan, CHEN Yun, ZHANG Qibing, MA Yiming, XIE Chenglan. Effects of electroacupuncture on cognitive function and inflammatory factors in elderly patients undergoing lower limb orthopedic surgery during the perioperative period [J]. Practical Geriatrics, 2024, 38(9): 944-947.
[6]	LI Xiaomin, LI Xiaolin, LI Jie, WU Lei, HAO Ranran. Efficiency influencing factors of transanal double-balloon enteroscopy in elderly patients [J]. Practical Geriatrics, 2024, 38(9): 958-961.
[7]	CAI Huicui, CHEN Yan, WANG Yan, YE Jinjun, ZHU Yuying. Effects of diversified health education model with simple respiratory function exercise on cancer-related fatigue and compliance behavior in elderly patients with lung cancer receiving radiotherapy [J]. Practical Geriatrics, 2024, 38(9): 968-972.
[8]	WANG Xiaojiao, WANG Ning, CUI Hong, YE Tong, WANG Xiaoming. Influence of exercise rehabilitation in elderly patients with mild to moderate chronic heart failure [J]. Practical Geriatrics, 2024, 38(8): 775-778.
[9]	SHEN Chenjun, WANG Xiaoqing, TANG Degang, NING Ping. Correlation between standardized uric acid and renal function in elderly patients with chronic kidney disease aged 90 and over [J]. Practical Geriatrics, 2024, 38(8): 779-782.
[10]	HAO Shijie, ZOU Jianpeng, WEI Chen, LIU Qingjiang. Effect of comprehensive respiratory training on hypokinetic dysarthria in elderly patients with Parkinson’s disease [J]. Practical Geriatrics, 2024, 38(8): 783-787.
[11]	XIANG Chao, LUO Caidong. Analysis of the diagnostic value of T wave change of avL lead for the degree of coronary artery stenosis in elderly patients with coronary heart disease [J]. Practical Geriatrics, 2024, 38(8): 788-791.
[12]	LI Huiying, CAI Lili, ZHU Qiwei. Predictive value of plasma N-terminal pro-brain natriuretic peptide for prognosis in patients aged ≥80 years old with left ventricular hypertrophy [J]. Practical Geriatrics, 2024, 38(8): 797-801.
[13]	WANG Xinping, XIE Baimei, WEI Guo, YE Xiaoli, ZHAO Yayun, TAN Xiaotian. Expression levels and clinical significance of serum S100A9 and sCD163 in elderly patients with idiopathic interstitial pneumonia [J]. Practical Geriatrics, 2024, 38(8): 802-807.
[14]	LIU Meijuan, WANG Ning, WANG Dong, LU Fangzhou, LIU Juan. Effect of low-dose lidocaine combined with propofol on motor evoked potential in elderly patients undergoing intracranial tumor resection [J]. Practical Geriatrics, 2024, 38(8): 808-811.
[15]	LI Jingbing, WANG Huijun, WANG Shaoying, ZHAO Can, WANG Lidi, CAO Yujiao. Impacts of pentoxifylline combined with lipoic acid intervention on physical function and quality of life in elderly patients with frailty syndrome [J]. Practical Geriatrics, 2024, 38(8): 812-815.