{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T20:03:13Z","timestamp":1784577793085,"version":"3.55.0"},"reference-count":31,"publisher":"Sociedade Brasileira de Cardiologia","issue":"4","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  A les\u00e3o renal aguda associada ao contraste (LRA-AC) resulta em aumento da morbidade e mortalidade, hospitaliza\u00e7\u00e3o prolongada e piores desfechos cl\u00ednicos. Estudos anteriores demonstraram que limitar o volume de contraste (VC) a menos de 3 vezes a taxa de filtra\u00e7\u00e3o glomerular estimada (TFGe) implica menor risco de LRA-AC, e tanto a efic\u00e1cia quanto os melhores desfechos est\u00e3o associados a procedimentos coron\u00e1rios com volume de contraste ultrabaixo (VCU) (VC total \u2264 TFGe).  Objetivos  Esta revis\u00e3o sistem\u00e1tica e metan\u00e1lise teve como objetivo comparar os desfechos cl\u00ednicos da interven\u00e7\u00e3o coron\u00e1ria percut\u00e2nea (ICP) com VCU versus ICP convencional em pacientes com doen\u00e7a renal cr\u00f4nica.  M\u00e9todos  A busca foi realizada nas bases de dados PubMed\/MEDLINE, Cochrane, Embase, Scopus e Web of Science, incluindo todos os estudos que relataram desfechos cl\u00ednicos de ICP VCU. O desfecho prim\u00e1rio de efic\u00e1cia foi a incid\u00eancia de les\u00e3o renal aguda associada \u00e0 quimioterapia (LRA-AC), e os desfechos secund\u00e1rios foram a necessidade de di\u00e1lise, mortalidade por todas as causas e eventos cardiovasculares adversos maiores (MACE), definidos como o desfecho composto de mortalidade por todas as causas, infarto do mioc\u00e1rdio n\u00e3o fatal e revasculariza\u00e7\u00e3o da les\u00e3o-alvo clinicamente indicada.  Resultados  Seis estudos atenderam aos crit\u00e9rios de inclus\u00e3o e foram inclu\u00eddos na an\u00e1lise final, abrangendo um total de 274.102 pacientes. A ICP VCU foi associada \u00e0 redu\u00e7\u00e3o estatisticamente significativa da LRA-AC (raz\u00e3o de risco = 0,27; IC 95% = 0,13\u20130,56; p = 0,0004) que foi observada. Por outro lado, a ICP VCU n\u00e3o resultou em redu\u00e7\u00e3o estatisticamente significativa da necessidade de di\u00e1lise (raz\u00e3o de risco = 0,33; IC 95% = 0,06\u20131,72; p = 0,186), mortalidade por todas as causas (raz\u00e3o de risco = 0,48; IC 95% = 0,17\u20131,39; p = 0,18) e eventos cardiovasculares adversos maiores (MACE) (raz\u00e3o de risco = 0,52; IC 95% = 0,21\u20131,30; p = 0,16).  Conclus\u00f5es  A ICP VCU, em compara\u00e7\u00e3o com a ICP convencional, em pacientes com doen\u00e7a renal cr\u00f4nica, se mostrou segura, vi\u00e1vel e associada a uma redu\u00e7\u00e3o estatisticamente significativa da LRA-AC. Ensaios adicionais, de maior porte, randomizados e controlados, s\u00e3o necess\u00e1rios para confirmar essas descobertas.<\/jats:p>","DOI":"10.36660\/abc.20250660","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T19:26:02Z","timestamp":1784575562000},"source":"Crossref","is-referenced-by-count":0,"title":["Interven\u00e7\u00e3o Coron\u00e1ria Percut\u00e2nea com Volume de Contraste Ultrabaixo versus Interven\u00e7\u00e3o Coron\u00e1ria Percut\u00e2nea Convencional em Pacientes com Insufici\u00eancia Renal Pr\u00e9-Existente: Uma Revis\u00e3o Sistem\u00e1tica e Metan\u00e1lise de Desfechos Cl\u00ednicos"],"prefix":"10.36660","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6953-8544","authenticated-orcid":false,"given":"Marcos Danillo","family":"Oliveira","sequence":"first","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6252-6708","authenticated-orcid":false,"given":"Ricardo Fonseca Oliveira","family":"Suruagy-Motta","sequence":"additional","affiliation":[{"name":"Universidade Cesmac,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5238-1339","authenticated-orcid":false,"given":"Leonardo Dexheimer da","family":"Silva","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6592-4023","authenticated-orcid":false,"given":"Karlos Daniell Ara\u00fajo dos","family":"Santos","sequence":"additional","affiliation":[{"name":"Universidade Federal de Roraima,  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