LETTER
Patient Care after Percutaneous Coronary Artery Interventions
Peter A. McCullough, MD, MPH, and
William W. O'Neill, MD
1 April 1998 | Volume 128 Issue 7 | Page 598
TO THE EDITOR:
In a review of complications after coronary intervention [1], O'Meara and Dehmer state that the incidence of contrast nephropathy after such intervention is unknown. They also state that renal failure due to this condition is nonoliguric and rarely requires dialysis and that most patients have an uneventful course.
In the past year, we presented results from a cohort study regarding this problem in patients after coronary intervention [2-4]. In a derivation set of 1826 consecutive patients, we found the incidence of contrast nephropathy (defined as a transient increase in serum creatinine level >25% above baseline) to be 144.6/1000 cases. The incidence of acute renal failure requiring dialysis was 7.7/1000. The mean in-hospital mortality rate for patients who required dialysis was 35.7%, and the 2-year survival rate was 18.8%. The mortality rate for patients without acute renal failure was 1.1%, and the rate for patients with renal failure who did not require dialysis was 7.1%.
We agree that contrast nephropathy requiring dialysis is rare (incidence < 1%). When it does occur, however, it is associated with high in-hospital mortality rates and poor long-term survival. This example points out the need for Annals and other journals to adopt explicit review and search criteria for summary articles so that the published papers include the most comprehensive and contemporary studies available in full-length and abstract form. In this instance, we believe that this additional information aids in the authors' mission to provide the specialist with a firm working knowledge of complications after coronary intervention.
|
Author and Article Information
|
|---|
Henry Ford Hospital; Detroit, MI 48202
William Beaumont Hospital; Royal Oak, MI 48073
1. O'Meara JJ, Dehmer GJ. Care of the patient and management of complications after percutaneous coronary artery interventions. Ann Intern Med. 1997; 127:458-71.
2. McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW. Acute contrast nephropathy after coronary intervention: incidence, risk factors, and relationship to mortality [Abstract]. J Am Coll Cardiol. 1996; 27(Suppl A):304A-5A.
3. McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW. Acute contrast nephropathy after coronary intervention: prediction of dialysis and related mortality in the elderly [Abstract]. Am J Geriatr Cardiol. 1996; 5:52.
4. McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med. 1997; 103:368-75.
About Letters
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
Top
Author & Article Info
References
Article
