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Endothelial dysfunction prevalent in PCI patients; 33.7% developed contrast-associated AKI

Endothelial dysfunction prevalent in PCI patients; 33.7% developed contrast-associated AKI
Photo by Navy Medicine / Unsplash
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.

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
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