Endothelial dysfunction prevalent in PCI patients; 33.7% developed contrast-associated AKIStudy finds kidney injury link to blood vessel health after heart procedures

Frontiers in Medicine Published April 2, 2026 DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Note the observational association between prevalent endothelial dysfunction and CA-AKI risk post-PCI.

This prospective observational longitudinal cohort study followed 187 patients (mean age 61.1 years, 134 males) undergoing percutaneous coronary intervention (PCI) with iodinated contrast. The primary outcome was contrast-associated acute kidney injury (CA-AKI), assessed via creatinine at baseline, 24 hours, and 48-72 hours post-procedure, with renal function also checked at one month.

The study reported 60 cases of CA-AKI, representing 33.7% of the cohort. A key finding was the high prevalence of endothelial dysfunction, defined by an Endothelial Quality Index (EQI) below 2.0, which was present in 178 patients (95.2%). The mean EQI was 0.86 ± 0.61. The study population also had a high prevalence of type 2 diabetes (56.7%).

Safety and tolerability data were not reported. The study's primary limitation is its observational design, which can identify associations but cannot establish causation between endothelial dysfunction and CA-AKI. The absence of a comparator group and unreported effect sizes or confidence intervals further limit causal inference. The findings suggest endothelial health may be a relevant factor in a population at risk for CA-AKI, but they do not support specific preventive measures.

Researchers wanted to understand what factors might predict kidney injury after heart procedures using contrast dye. They followed 187 patients (134 men, 53 women, average age 61) who needed a procedure called percutaneous coronary intervention (PCI). The team checked patients' kidney function before the procedure, then again 24 hours, 48-72 hours, and one month after they received the dye.

They found that 60 out of the 187 patients (33.7%) developed contrast-associated acute kidney injury (CA-AKI). The study also measured the health of patients' blood vessels, known as endothelial function, before the procedure. The results showed that 178 out of 187 patients (95.2%) already had poor blood vessel health.

This study did not report any specific safety concerns or side effects from the procedures. The main reason to be careful with these results is that this was an observational study. This means researchers observed what happened but did not test an intervention. They found that poor blood vessel health and kidney injury happened in the same group of people, but they cannot prove that one caused the other.

Readers should understand that this research identifies a potential link between two common conditions in heart patients. It does not provide new treatment advice or prove that improving blood vessel health will prevent kidney injury. The findings highlight an area for future research to explore more carefully.

What this means for you:

Poor blood vessel health was common in patients who later developed kidney injury after a heart procedure, but more research is needed.

Study Details

Study typeCohort

EvidenceLevel 3

PublishedMar 2026

View Original Abstract ↓

BackgroundContrast-Associated Acute Kidney Injury (CA-AKI) is a major cause of acute kidney injury in hospitalized patients, which is triggered by the administration of iodinated contrast agents during computed tomography scans and angiographic procedures. It significantly elevates cardiovascular risk and stands as a major complication of coronary angiography, contributing to a marked deterioration in patient prognosis with elevated rates of morbidity and mortality.AimOur main goal was to assess the predictive factors of CA-AKI and investigate a possible association between pre-existing endothelial dysfunction and the occurrence of CA-AKI following Percutaneous Coronary Interventions (PCI). We also intended to explore possible preventive measures of CA-AKI.MethodsWe conducted a prospective observational longitudinal study enrolling patients with an indication for PCI. Patients underwent an assessment of renal function (baseline creatinine, 24h and 48-72h after administration of contrast agent). We also evaluated renal function at one month as a secondary endpoint. Then, we analyzed Endothelial Quality Index (EQI) by Finger Thermal Monitoring (FTM) with E4 diagnosis Polymath.ResultsWe enrolled 187 patients (134 males, 53 females) in our study with a mean age of 61.1± 11.8 years. Over half (56.7%) were type 2 diabetes. A total of 60 cases of CA-AKI were reported (33.7%). The mean EQI was 0.86 ± 0.61. The vast majority of our study population (n=178; 95.2%) had endothelial dysfunction (EQI

Endothelial dysfunction prevalent in PCI patients; 33.7% developed contrast-associated AKIStudy finds kidney injury link to blood vessel health after heart procedures

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