Comparative Study of Different Predictive Values of Risk Scores for Predicting Contrast Induced Nephropathy and Short Outcome after Primary Percutaneous Coronary Interventions (original) (raw)

Epidemiology and Prognostic Implications of Contrast-Induced Nephropathy

The American Journal of Cardiology, 2006

g on behalf of the CIN Consensus Working Panel Contrast-induced nephropathy (CIN), usually defined as an increase in serum creatinine of 0.5 mg/dL (44.2 mol/L), or a 25% increase from the baseline value 48 hours after the procedure, is a common and potentially serious complication of the use of iodinated contrast media in patients at risk of acute renal injury. It is an important cause of hospital-acquired renal failure, responsible for approximately 11% of cases. CIN may be difficult to distinguish from cholesterol embolization, another cause of postprocedure renal impairment. The reported incidence of CIN varies depending on the patient population studied. The impact of postprocedural renal impairment on clinical outcomes has been evaluated most extensively in patients undergoing percutaneous coronary intervention. CIN is associated with increased mortality both in hospital and at 1 year. A higher incidence of in-hospital and late cardiovascular events, as well as longer hospital stays, has been reported in patients developing CIN. In a small proportion of patients, CIN is severe enough to require dialysis, and these patients have a particularly poor prognosis. Many of the risk markers for CIN are also predictive of a worse prognosis.

A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention

Journal of the American College of Cardiology, 2004

A simple risk score for prediction of contrast-induced nephropathy after This information is current as of OBJECTIVES We sought to develop a simple risk score of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI). BACKGROUND Although several risk factors for CIN have been identified, the cumulative risk rendered by their combination is unknown.

Risk score of contrast-induced nephropathy in patients after percutaneous coronary intervention

2021

Risk score of contrast-induced nephropathy in patients after percutaneous coronary intervention Morlim Limbong1*, Yan Herry2, Pipin Ardhianto2, Suhartono3 Background: Contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) is still an issue in modern revascularization era. Recent risk stratification model used creatinine as biomarker which has some limitations. Increased ≥ 10 % of Cystatin-C after PCI has proven to be one of the earliest and accurate CIN after PCI biomarkers. The study aims to develop risk score based on predictors of contrast-induced nephropathy in patients after PCI with Cystatin-C as biomarker. Methods: A prospective cohort study of 129 patients after PCI at Dr. Kariadi General Hospital Semarang. Predictor analysis was carried out using bivariate chi-square test and multivariate logistic regression. The independent predictors obtained were then used as risk score variables. The Hosmer and Lemeshow calibration test and AUC ROC analysis fo...

Incidence of contrast-induced nephropathy a prospective study

Journal of Renal Injury Prevention

Introduction: Contrast-induced acute kidney injury (AKI) is one of the most common causes of hospital-acquired AKI. Objectives: To determine the incidence of contrast induced nephropathy (CIN), to identify significant risk factors associated with CIN and to compare the variations in serum creatinine levels with and without contrast exposure. Patients and Methods: A total of 222 patients (124 males and 98 females with mean age of 48.96 ± 16.74 years) who received iodinated contrast agents during different procedures over a period of 18 months were included in the study. CIN was defined as a relative increase of >25% or an absolute increase of > 0.5 mg/dL in serum creatinine levels 4 days post-procedure. 148 patients (82 males and 66 females with mean age of 47.48 ± 17.21 years) who did not receive any contrast agent were included as controls to determine the frequency with which the variations in serum creatinine levels fulfilled the definition of CIN. Results: The overall incidence of CIN was 12.6%. Incidence of CIN was 32.6% after percutaneous coronary intervention (PCI) and 7.38% after IV contrast exposure (P < 0.0001). Multivariate logistic regression analysis of risk factors revealed heart failure (P = 0.001), pre-procedure serum creatinine level ≥ 1.5 mg/dL (P = 0.005) and nature of contrast agent (P = 0.001), as independent risk factors of CIN. 2.02% patients in control group showed variations in serum creatinine levels within the range corresponding to the definition of CIN. Conclusion: Heart failure, pre-procedural serum creatinine of ≥ 1.5 mg/dL and the nature of contrast agent are independent predictors of CIN.

Risk factors and clinical outcomes for contrast-induced nephropathy after percutaneous coronary intervention in patients with normal serum creatinine

Annals of the Academy of Medicine, Singapore, 2010

We aim to examine the risk predictors of contrast-induced nephropathy (CIN) in patients with normal baseline serum creatinine (Cr). CIN is an important complication postpercutaneous coronary intervention (PCI). Previous studies examined CIN predictors in patients with chronic renal impairment. No large studies investigated patients with normal renal function which constitute the majority undergoing PCI. We aim to identify risk predictors in this cohort and examine the clinical outcomes. A total of 3036 patients with normal baseline Cr (<1.5 mg/dL) who did not receive prophylaxis while undergoing PCI were enrolled. We examined the occurrence of CIN and the mortality outcome at 1 and 6 months. CIN occurred in 7.3% of patients. The median age was 59.5 years (range, 26 to 86), 78.7% men, 34.6% diabetics. Risk predictors for CIN include age [odds ratio (OR), 6.4; 95% CI, 1.01-13.3; P = 0.042], female gender (OR, 2.0; 95% CI, 1.5-2.7; P = 0.001), abnormal left ventricular ejection frac...

Comparison of Risks and Clinical Predictors of Contrast-Induced Nephropathy in Patients Undergoing Emergency versus Nonemergency Percutaneous Coronary Interventions

Journal of Interventional Cardiology, 2010

therapy. Methods: A cohort of 8,798 patients who underwent PCI from May 2000 to April 2008 was enrolled. We divided patients into 3 groups. A: STEMI patient undergoing primary PCI; B: UA/NSTEMI patients undergoing early PCI; C: Patients without MI undergoing elective PCI. Pre-PCI saline hydration was given to group B and C if baseline glomerular filtration rate (GFR) <60 ml/min/1.73 m 2 . Results: Mean age was 57.4 years; 35.9% was diabetics. Incidence of CIN were 12.0%, 9.2%, and 4.5%, in group A, B and C (P = <0.0005). CIN correlated with higher mortality (15.5% vs. 1.3%, P < 0.0005) at 1 month. The important predictors of CIN were age >70, female gender, anemia, low systolic BP < 100 mmHg, high creatinine kinase level, abnormal LVEF, baseline renal impairment, MI and insulin dependent diabetes. Incidence of CIN in patients with GFR >60 were 8. 2%, 9.2%, and 4.3% in group A, B, and C respectively (p < 0.0005). Incidence of CIN in patients with GFR = 30-60 were 19.1%, 4.5%, and 2.4% (p < 0.0005) and in patients with GFR < 30 were 34. 4%, 40.0%, and 25.9% (p = 0.510). Conclusions: Pre-hydration prophylaxis was effective in preventing CIN in mild renal impaired patients but are less so in more severely renal impaired patients (GFR < 30). STEMI patients undergoing primary PCI regardless of baseline GFR were at high risk. Accelerated prophylactic regime can be considered in this cohort. (J Interven Cardiol 2010;23:451-459)

Predicting contrast-induced nephropathy after percutaneous coronary intervention: Do we need formulas? A cardiological perspective

Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2018

Contrast-induced nephropathy (CIN) features as an increasingly frequent diagnosis in the field of interventional cardiology. This is due to increased use of iodine-based contrast agents in cardiovascular diagnostic and therapeutic procedures performed in patients with multiple comorbidities, as well as in ever more complex clinical and angiographic settings that require lengthy or staged procedures. CIN is estimated to be the third leading cause of renal failure among in-patients, accounting for 11-12% of cases. 1 According to some studies, its incidence can reach 25-30% in elderly patients, especially those with diabetes, ST-segment elevation acute coronary syndrome, left ventricular dysfunction or chronic renal failure (CRF). A subgroup at greater risk of developing CIN is those with concomitant diabetes and CRF.

Simplifying contrast-induced acute kidney injury prediction after primary percutaneous coronary intervention: the age, creatinine and ejection fraction score

Cardiovascular intervention and therapeutics, 2017

Contrast-induced acute kidney injury (CI-AKI) is a common event after percutaneous coronary intervention (PCI). Presently, the main strategy to avoid CI-AKI lies in saline hydration, since to date none pharmacologic prophylaxis proved beneficial. Our aim was to determine if a low complexity mortality risk model is able to predict CI-AKI in patients undergoing PCI after ST elevation myocardial infarction (STEMI). We have included patients with STEMI submitted to primary PCI in a tertiary hospital. The definition of CI-AKI was a raise of 0.3 mg/dL or 50% in post procedure (24-72 h) serum creatinine compared to baseline. Age, glomerular filtration and ejection fraction were used to calculate ACEF-MDRD score. We have included 347 patients with mean age of 60 years. In univariate analysis, age, diabetes, previous ASA use, Killip 3 or 4 at admission, ACEF-MDRD and Mehran scores were predictors of CI-AKI. After multivariate adjustment, only ACEF-MDRD score and diabetes remained CI-AKI pred...