Risk of acute kidney injury less with higher time interval between angiography and CABG

There is an inverse relation between the time to cardiac surgery after angiography and acute kidney injury. Mehta RH and associates [Relationship of the Time Interval Between Cardiac Catheterization and Elective Coronary Artery Bypass Surgery With Postprocedural Acute Kidney Injury. Circulation. 2011; 124: S149-S155] recently analyzed the data from about two thousand five hundred patients undergoing elective coronary artery bypass surgery (CABG) and confirmed this relationship. The risk of acute kidney injury was highest in those who had CABG within a day of cardiac catheterization, with a mean of twenty four percent vs a mean of about sixteen percent in those who underwent surgery five or more days later. Acute kidney injury was defined as an increase in post CABG serum creatinine of fifty percent or more higher than the baseline value or a new need for dialysis. Post coronary artery bypass grafting acute kidney injury was associated with higher long term risk of death (hazard ratio of 1.268). The authors suggest further studies regarding the utility of delaying elective CABG more than twenty four hours after exposure to contrast agents when feasible with regard to reducing post CABG acute kidney injury.

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