Risk of acute kidney injury in patients who undergo coronary angiography and cardiac surgery in close succession

Byungsoo Ko, Santiago Garcia, Salima Mithani, Venkat Tholakanahalli, Selcuk Adabag

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


AimsCardiac surgery and coronary angiography are both associated with risk of acute kidney injury (AKI). We hypothesized that the risk of post-operative AKI increases when coronary angiogram and cardiac surgery are performed in close succession, without sufficient time for recovery from the adverse effects of intravenous contrast. Methods and resultsWe included 2133 consecutive patients who underwent cardiac surgery at the Minneapolis Veterans Administration Medical Center from 2004 to 2010. Acute kidney injury was defined by the AKI network and the Risk, Injury, Failure, Loss, End-stage (RIFLE) criteria. Patients were 66 ± 10 years old. Mean pre-operative creatinine and estimated glomerular filtration rate were 1.1 ± 0.4 mg/dL and 75 ± 22 mL/min/1.73 m2, respectively. Cardiac surgery was performed 14 days (range 0235) after coronary angiography. Acute kidney injury occurred in 680 (32) patients per AKI network, 390 (18) patients per RIFLE risk, and 111 (5) patients per RIFLE injury criteria. Age, body mass index, diabetes mellitus, New York Heart Association class III/IV, cardiopulmonary bypass time, and impaired pre-operative renal function were independent predictors of AKI. However, time between coronary angiogram and cardiac surgery was not a predictor (P = 0.41). AKI occurred in 35 of 433 patients operated within 3 days of coronary angiogram vs. 31 of 1700 patients operated after 3 days (P = 0.17). Results were the same in patients with impaired pre-operative renal function and those with contrast-induced nephropathy. ConclusionRisk of AKI after cardiac surgery is not influenced by the time between coronary angiogram and cardiac surgery. These results do not support the notion of delaying cardiac surgery for the sole purpose of renal recovery after coronary angiogram.

Original languageEnglish (US)
Pages (from-to)2065-2070
Number of pages6
JournalEuropean heart journal
Issue number16
StatePublished - Aug 2012


  • Acute kidney injury
  • Cardiac surgery
  • Coronary angiogram
  • Outcome
  • Surgery complications


Dive into the research topics of 'Risk of acute kidney injury in patients who undergo coronary angiography and cardiac surgery in close succession'. Together they form a unique fingerprint.

Cite this