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The aim of the current study is to evaluate prospectively whether concomitant administration of renin-angiotensin-aldosterone system (RAAS) blockers (namely ACE-I and ARBs') influence the change in estimated glomerular filtration rate or GFR (eGFR) after administration of contrast media in patients undergoing non-emergent coronary angiography.
Contrast-induced nephropathy (CIN) is defined as an absolute or relative increase in serum creatinine compared to the baseline values, together with exposure to a contrast agent and exclusion of alternative explanations for renal impairment. Most frequently the renal impairment develops 48 hours post exposure. Although RAAS blocking agents are widely used among patients requiring contrast studies, data regarding the effect of these agents on the development of CIN are sparse and inconsistent. Patients undergoing percutaneous coronary intervention are frequently treated with RAAS blocking agents. Despite the not infrequent occurrence of CIN following percutaneous coronary intervention (PCI) no guidelines are available on the topic of the cessation of the RAAS inhibitors prior to the procedure.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| control | No Intervention | continue with treatment with angiotensin converting enzyme inhibitor or angiotensin blocker during all study period | |
| drug stop | Experimental | temporary stop of angiotensin converting enzyme inhibitor and angiotensin blocker treatment at least 72 hours before coronary angiography and renew of treatment 72 hours after angiography |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| stop angiotensin converting enzyme inhibitor or angiotensin receptor blocker (ACE-I/ARB) | Procedure | stoping for 6 days treatment with angiotensin converting enzyme inhibitor or angiotensin receptor blocker |
| Measure | Description | Time Frame |
|---|---|---|
| change in eGFR from baseline to 48-72 hours following the exposure to the contrast. | 48 AND 72 HOURS AFTER EXPOSURE TO CONTRAST MEDIA |
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Inclusion Criteria:
Exclusion Criteria:
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Dec 27, 2016 | |
| Reset | Feb 15, 2017 | |
| Release | Jun 22, 2017 | |
| Reset | Jan 31, 2018 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Dec 27, 2016 | Feb 15, 2017 | |||
| Jun 22, 2017 |
| ID | Term |
|---|---|
| D057911 | Angiotensin Receptor Antagonists |
| ID | Term |
|---|---|
| D045504 | Molecular Mechanisms of Pharmacological Action |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
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| Jan 31, 2018 |