β-blockers might be associated with a reduced risk of contrast-induced acute kidney injury in acute myocardial infarction patients

Background: Contrast-induced acute kidney injury (CI-AKI) is a common complication of coronary angiography (CAG) which is associated with worse prognosis. Some studies indicated beta-blockers could preserve renal function among acute myocardial infarction (AMI) patients, but the relationship between beta-blockers and CI-AKI has not been well documented among AMI patients who underwent CAG or percutaneous coronary intervention (PCI). Methods: In this prospective, observational study, 1,309 consecutive AMI patients who underwent CAG or PCI were recruited between January 2010 and December 2013. Patients were assigned into two groups according to beta-blockers use or non-use within 24 hours of the perioperative period [beta-blockers group (n=1,074) and non-beta-blockers group (n=235)]. Results: The overall incidence of CI-AKI was 247 (18.9%). CI-AKI was defined as an absolute increase of >0.5 mg/dL from baseline serum creatinine (SCr) within 48-72 h after contrast medium (CM) exposure. After multivariate adjusting, a total of 10 variables were related to CI-AKI, including beta-blockers [beta-blockers group vs. non-beta-blockers group: odds ratio (OR) =0.520, 95% confidence interval (CI), 0.291-0.930; P=0.027], age, diabetes mellitus, estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2), left ventricular ejection fraction (LVEF) <40%, use of intra-aortic balloon pump (IABP), peri-hypotension, emergent PCI, coronary lesions and CM dose >200 mL. During the mean follow-up of 2.35 +/- 0.99 years, the beta-blockers group was significantly associated with lower long-term mortality [beta-blockers group vs. non-beta-blockers group: adjusted hazard ratio (HR) = 0.43, 95% CI, 0.27-0.71; P=0.001] among AMI patients. Conclusions: For AMI patients who are undergoing CAG or PCI, taking beta-blockers might be associated with lower rates of CI-AKI and long-term mortality.