INCIDENCE OF ATHEROEMBOLIC RENAL-FAILURE AFTER CORONARY ANGIOGRAPHY -A PROSPECTIVE-STUDY

Atheroembolic renal failure (AERF) is often seen after vascular proced ures in elderly atherosclerotic patients. To estimate the incidence of AERF after coronary angiography, all patients undergoing coronary ang iography at the V.A. Medical Center, Dayton, were prospectively evalua ted for AERF. Since, unlike contrast nephropathy, AERF develops about a week after the vascular procedure and persists or progresses over we eks and months, serum creatinine was measured just prior to and 3 week s after coronary angiography. Peripheral signs of cholesterol emboli w ere also looked for at follow-up visits. Two hundred sixty-seven patie nts underwent coronary angiography over a fifteen-month period. Most o f the patients were sixty years old or older. Mean serum creatinine in these patients prior to coronary angiography was 1.2 mg/dL. Mean seru m creatinine after coronary angiography was unchanged (1.2 mg/dL). Onl y 7 patients had serum creatinine > 2 mg/dL prior to coronary angiogra phy. Two patients died within a week of coronary angiography and 2 did not return for follow-up. Of the remaining 263 patients, 5 had a seru m creatinine increase by 0.5 mg/dL or more at three weeks after corona ry angiography. Three of 5 had a serum creatinine increase by 1.0 mg/d L or more. Two of these 3 patients eventually died of renal failure. N one of these 5 patients had peripheral signs of cholesterol emboli. In selected patients, the incidence of AERF after coronary angiography a ppears to be very low (< 2%).