Pre-Procedural Glucose Levels and the Risk for Contrast-Induced Nephropathy in Diabetic Patients Undergoing Coronary angiography or Percutaneous Coronary Intervention

Diabetes mellitus is an independent risk factor for Contrast-induced nephropathy (CIN) in patients undergoing Coronary arteriography (CAG)/percutaneous coronary intervention (PCI). This study aimed to evaluate whether pre-procedural glucose levels in diabetic patients who received CAG/PCI had an impact on the occurrence of postoperative CIN. We reviewed the incidence of pre-procedural glucose and postoperative CIN in 532 patients with CAG/PCI from June 1, 2020 to January 31, 2021 in Tianjin Chest Hospital, and divided the preoperative pre-procedural glucose levels into 5 groups. Blood samples were collected at admission, 48h and 72h after operation to measure the serum creatinine (Scr) value of patients. We found Patients with elevated pre-procedural glucose had higher BMI, and they were more often on therapy with PCI. They also had higher basal, 24h and 48h Scr. (Table 1) The incidence of CIN in the 5 groups of patients were: 6.9%, 10.7%, 14.1%, 20.1%, 26.0%. (p = 0.030) The multivariate analysis confirmed that in the main high-risk subgroup, patients with elevated pre-procedural glucose levels (≥ 158mg/dl) had a higher risk of CIN disease. (Fig. 2) Trend test showed the change of HR (1.000, 1.646, 2.285, 3.227, 4,788). (Table 2) We come to the conclusion that in diabetic patients undergoing CAG/PCI, elevated pre-procedural glucose is independently associated with the risk of CIN, and with the increase of pre-procedural glucose level, the incidence of CIN gradually increases.