Preoperative Fasting Blood Glucose Levels and the Risk of Contrast-Induced Nephropathy in Patients With Diabetes and Pre-diabetes Undergoing Coronary Arteriography or Percutaneous Coronary Intervention: A Cross-Sectional Study

Angiology. 2022 Aug;73(7):660-667. doi: 10.1177/00033197211061916. Epub 2022 Jan 27.

Abstract

Diabetes mellitus is an independent risk factor for contrast-induced nephropathy (CIN) in patients undergoing coronary arteriography/percutaneous coronary intervention (CAG/PCI). We evaluated whether preoperative fasting blood glucose (FBG) levels in diabetic and pre-diabetic patients who underwent CAG/PCI influenced the occurrence of CIN. From June 1, 2020, to February 28, 2021, 687 patients were divided into five groups based on their preoperative FBG levels. Blood samples were collected at admission and at 48 hours and 72 hours after the procedure to determine serum creatinine levels. The P value for trend was used to analyze the trend between preoperative FBG levels and the increased risk of CIN. Univariable and multivariable logistic regression analysis were used to exclude the influence of confounding factors, and some high-risk confounders were selected for subgroup analysis. The results of our cross-sectional study show that elevated preoperative FBG levels are independently associated with the risk of CIN in diabetic and pre-diabetic patients undergoing CAG/PCI. Furthermore, the incidence of CIN gradually increases with the rise in preoperative FBG levels. Patients with elevated preoperative FBG at admission should be carefully monitored and more active measures should be taken to prevent CIN.

Keywords: contrast-induced nephropathy; coronary arteriography; diabetes mellitus; percutaneous coronary intervention; preoperative fasting blood glucose; risk factors.

MeSH terms

  • Blood Glucose
  • Contrast Media / adverse effects
  • Coronary Angiography / adverse effects
  • Coronary Angiography / methods
  • Creatinine
  • Cross-Sectional Studies
  • Diabetes Mellitus* / epidemiology
  • Fasting
  • Humans
  • Kidney Diseases* / chemically induced
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / methods
  • Prediabetic State* / complications
  • Prediabetic State* / diagnosis
  • Risk Factors

Substances

  • Blood Glucose
  • Contrast Media
  • Creatinine