Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
CTA and Contrast-Induced Neuropathy Risk Factors
J Stroke Cerebrovasc Dis; ePub 2018 Dec 6; Rowe, et al
Ischemic stroke patients with a history of diabetes mellitus, or not taking medications prior to admission, should be monitored closely for the development of contrast-induced nephropathy (CIN) when receiving a computed tomography angiography (CTA), according to a recent study. Researchers analyzed a single-center, nested, case-control study of patients with ischemic stroke who received a CTA between June 18, 2012, and January 1, 2016. Patients were grouped based on development of CIN. A total of 209 patients were included in the final analysis (178 controls, 31 cases). They found:
- The prevalence of CIN during the time period studied was 14.8%.
- A higher proportion of patients who developed CIN had a history of diabetes mellitus (37 [20.56%] vs 15 [48.39%]) and reported taking no medications prior to admission (35 [19.44%] vs 11 [35.48%]).
- However, a lower proportion of patients who developed CIN had a history of smoking (59 [32.78] vs 3 [9.68]).
- After statistical adjustment, only a history of diabetes, taking no medications prior to admission, and a self-reported history of smoking remained associated with the development of CIN.
Rowe AS, Hawkins B, Hamilton LA, et al. Contrast-induced nephropathy in ischemic stroke patients undergoing computed tomography angiography: CINISter Study. [Published online ahead of print December 6, 2018]. J Stroke Cerebrovasc Dis. doi:10.1016/j.jstrokecerebrovasdis.2018.11.012.