Effect Of Vitamin E For Preventing The Contrast Induced Acute Kidney Injury In Patients With Coronary Artery Disease After Percutaneous Coronary Intervention

ObjectiveTo study the protective effect of vitamin E in preventing contrast induced acute kidney injury (CIAKI) in patient with coronary artery disease (CAD) after percutaneous coronary intervention (PCI).MethodsWe prospective to be included in our hospital in November of 2014 to April 2015 on line undergoing elective percutaneous coronary intervention (PCI) in patients with 206 cases, using the stochastic indicator method is divided into two groups:control group and treatment group. Control group 104 cases,76 cases of male, the female 28 cases, the average age (65.2±15.1); Treatment group 102 cases, among which 65 were male, female 37 cases, the average age (67.6±13.9). Two groups of patients in the preoperative and postoperative 6-12 h to give 0.9% saline at 1 ml/(kg.h) intravenous drip water injection treatment [with left ventricular ejection fraction (LVEF)≤40% or New York heart association (NYHA) heart function class acuity III static drop dose by half]; Treatment group on the basis of hydration treatment 1 day before operation, operation on the same day morning,2h after surgery, postoperative 8 h and 24 h after 5 time points each oral vitamin E soft capsules (H35020242 approved by the state and the star shark pharmaceutical co, LTD. each 100 mg) 300 mg, total 1500 mg. Records of two groups of patient’s age, gender, uric acid value, LVEF, preoperative medication, fasting glucose, whether to have some basic history, etc. Observe the changes of renal function indexes in two groups of preoperative and postoperative serum creatinine (Scr), blood urea nitrogen (Bun), cystatin C (Cys-C), creatinine clearance (Ccr), compare two groups of CIAKI risk of the disease. Using multiariable Logistic regression model analysis of CIAKI independent risk factors. CIAKI is refers to the use of contrast medium within 48 h of elevated serum creatinine than baseline levels of 25% or more than 44.2umol/L and can not use other reasons of acute kidney injury.ResultsTwo groups of patients on the basis of the age, proportion of gender, disease, drug use situation and Mehran score comparison differences had no statistical significance (P> 0.05). Overall, there were 19 (9.22%) patients suffered from CIAKI, the occurrence rate in Treatment group (4.90%) was lower than Control group (13.46%) (x2=4.506, P=0.034). Patients with hypertensions、diabetes、chronic kidney diseases、anemia and mehran risk score<10 exhibited significantly lower incidences of CIN development in the treatment group than the control group (P<0.05). In control group, the levels of Scr and Bun were significantly higher while Ccr was significantly lower in postoperation than preoperation. Comparison between the two groups after postoperation 48h, the Scr was significantly lower while the Ccr was significantly higher in treatment group than in control group after PCI (P<0.05). Multivariate regression analysis revealed that aged over 75 years, diabetes, chronic kidney diseases and mehran risk score>10 were the independent risk factors for CIAKI occurrence.ConclusionShort-term application of vitamin E may reduce the risk of CIAKI occurrence at certain degree in CAD patients after PCI.