scholarly journals Value of CHA2DS2-VASc score and safe contrast volume for early detection of contrast induced nephropathy after percutaneous coronary intervention

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
W Khalil ◽  
M Gouda ◽  
M Gamal ◽  
M Alshaer
Keyword(s):  
Early Detection ◽  
Multivariate Logistic Regression Analysis ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Large Area ◽  
Characteristic Analysis ◽  
Clearance Ratio ◽  
Contrast Induced Nephropathy ◽  
Coronary Syndrome ◽  
Contrast Volume

Abstract Background The CHA2DS2-VASc score is utilized to order the danger of embolization in atrial fibrillation (AF). Also it has been assessed to expect the worse clinical scenario in acute coronary syndrome patients, regardless of having AF. Therefore, the study aim was to use CHA2DS2-VASc score that has such a large area of use and the safe contrast volume – that represented by volume of the dye to creatinine clearance ratio (V/CrCl) – for contrast induced nephropathy (CIN) early detection after PCI. Patients and methods A total of 259 patients who underwent elective or primary PCI were enrolled in the study. For each patient, The CHA2DS2-VASc score and V/CrCl was evaluated. The patients in our study were divided, according to CIN development to two groups. CIN was identified as a rise in serum creatinine >0.5 mg/dl or >25% increase in baseline within48 to 72 hours after PCI. Statistical analysis: the receiver operating characteristic analysis was used to detect the best cut off values to predict CIN, and we concluded the independent predictors of CIN through multivariate logistic regression analysis. Results There was significant positive correlation between Mehran score and CHA2DS2-VASc score. Independent predictors of CIN were Mehran score, V/CrCl ratio>3.2 and CHA2DS2-VASc >3, CHF or EF <40%, hypotension, anemia, primary PCI and weight. If the patient had (CHA2DS2-VASc score>3 or V/CrCl >3.2), as a single predictor, we can predict CIN with (sensitivity 96.97%, 95% CI 0.71 to 0.82). Conclusion The Mehran score, V/CrCl ratio and CHA2DS2-VASc score are strong predictors of CIN, and we can use CHA2DS2-VASc score and safe contrast volume for early detection of CIN after PCI. FUNDunding Acknowledgement Type of funding sources: None.

Association of monocyte to HDL cholesterol level with contrast induced nephropathy in STEMI patients treated with primary PCI

2017 ◽  
Vol 55 (1) ◽  
pp. 132-138 ◽  
Author(s):  
Saim Sağ ◽  
Abdülmecit Yıldız ◽  
Aysel Aydin Kaderli ◽  
Bülent Cuma Gül ◽  
Ömer Bedir ◽  
...  
Keyword(s):  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Coronary Intervention ◽  
Cardiovascular Outcomes ◽  
Primary Pci ◽  
Contrast Induced Nephropathy ◽  
Intravenous Contrast ◽  
St Segment Elevation ◽  
St Segment

Abstract Background: Contrast induced nephropathy (CIN) has been proven to be a clinical condition related to adverse cardiovascular outcomes. In recent studies, the monocyte to high density lipoprotein ratio (MHR) has been postulated as a novel parameter associated with adverse renal and cardiovascular outcomes. In this study we investigated the association of MHR with CIN in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). Methods: Consecutive STEMI patients treated with primary PCI were prospectively recruited. Subjects were categorized into two groups; as patients who developed CIN (CIN+) and patients who did not develop CIN (CIN–) during hospitalization. CIN was defined as either a 25% increase in serum creatinine from baseline or 44.20 µmol/L increase in absolute value, within 72 h of intravenous contrast administration. Results: A total number of 209 patients were included in the study. Thirty-two patients developed CIN (15.3%). In the CIN (+) patients, monocytes were higher [1.02 (0.83–1.39) vs. 0.69 (0.53–0.90) 109/L, p<0.01] and HDL cholesterol levels were lower [0.88 (0.78–1.01) vs. 0.98 (0.88–1.14) mmol/L, p<0.01]. In addition, MHR was significantly higher in the CIN (+) group [1.16 (0.89–2.16) vs. 0.72 (0.53–0.95) 109/mmol, p<0.01]. In multivariate logistic regression analysis, MHR, Mehran score, AGEF score and CV/eGFR were independently correlated with CIN. Conclusions: Higher MHR levels may predict CIN development after primary PCI in STEMI patients.

Abstract 12873: Blood Transfusion and the Risk of Contrast-Induced Nephropathy Among Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Wassef Karrowni ◽  
Amit N Vora ◽  
Dadi Dai ◽  
Daniel Wojdyla ◽  
Habib Dakik ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Blood Transfusion ◽  
Primary Outcome ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Contrast Induced Nephropathy ◽  
Coronary Syndrome ◽  
Post Procedure ◽  
Lower Baseline ◽  
Percutaneous Coronary

Introduction: Emerging scientific and clinical evidence suggests that blood transfusion might be risk factor for acute kidney injury. Hypothesis: Blood transfusion is independently associated with contrast-induced nephropathy (CIN) in acute coronary syndrome (ACS) patients undergoing PCI. Methods: Retrospective cohort study from the NCDR CathPCI Registry (2009-2014) (n=1,756,864). Primary outcome was CIN defined as rise in serum creatinine peak post-procedure ≥ 0.5 mg/dl or ≥ 25% above baseline. Results: CIN developed in 9.0% of the cohort; these patients were older (66.0 vs. 64.0 years; P<0.01), more often female (43.2% vs. 31.9%; P<0.01), and had more baseline comorbidities including DM (46.1%), hypertension (85.1%), and lower baseline GFR. Blood transfusion was utilized in 38,626 (2.2%) of patients. The adjusted OR for the risk of CIN with transfusion in the overall sample, patients with major bleeding, and patients with no bleeding were 4.87 (4.71-5.04), 2.21 (2.12-2.31), and 4.80 (4.40 - 5.24) respectively (Table). Association of CIN with transfusion was significantly increased across all pre-procedure hemoglobin (Hgb) levels and in stepwise fashion with increasing Hgb levels and regardless of post-procedure bleeding (Hgb &lt=10: adjusted OR (95%CI) 2.90 (2.75-3.05); Hgb &gt10 to &lt=13: 5.26 (5.06-5.48); Hgb &gt13 to &lt=15: 6.37 (5.99-6.78); Hgb &gt15 g/dl: 7.03 (6.43-7.67); Ptrend <0.01). Conclusions: Blood transfusion is strongly associated with CIN in ACS patients undergoing PCI. Whether a restrictive blood transfusion strategy lowers the risk of contrast nephropathy should be investigated.

scholarly journals Incidence and Predictors of Contrast Induced Nephropathy after Coronary Intervention at College of Medical Sciences Teaching Hospital, Bharatpur

2014 ◽  
Vol 11 (1) ◽  
pp. 3-11
Author(s):  
Sanjib Kumar Sharma ◽  
Laxman Dubey ◽  
Shankar Laudary ◽  
Sachin Dhungel ◽  
Madhav Ghimire ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Contrast Agent ◽  
Multivariate Logistic Regression Analysis ◽  
Sampling Technique ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Contrast Induced Nephropathy ◽  
Creatinine Concentration ◽  
Disease Study

Background and Aims: The implications of radio-contrast induced nephropathyare disastrous. In Nepal there is scarcity of data on contrast induced nephropathy. This observational descriptive study was undertaken to study the incidence of contrast induced nephropathy and to identify risk factors (predictors) for the development of contrast induced nephropathy in patients undergoing coronary angiography and angioplasty in atertiary care hospital. Methods: The subject consists of 540 patients undergoing coronary intervention from 2011 to 2013 were enrolled by convenient sampling technique. Two hundreds ten patients were excluded from the study. Therefore, a total of 330 patients were studied and analyzed. Contrast induced nephropathy was defined as an increase of >25% or >0.5 mg/dl in pre-catheterization serum creatinine at or after 48 h after percutaneous coronary intervention. Estimated glomerular filtration rate as calculated by applying the 4 variables Modification of Diet in Renal Disease Study equation. Standard definitions were used to define the variables. Results: Twenty seven (8.18%) patients experienced contrast induced nephropathy. The incidence of contrast induced nephropathy in patients with baseline creatinine clearance <60 ml/min was 45.9%. Contrast induced nephropathy developed in 10% of anemic and 12.5% diabetic patients. The amount of the contrast agent administered was similar for both groups of patients (138.20±91.34ml vs. 175.56±118.86ml; p =0.254). No correlation was found between the amount of contrast agent administered and the change of serum creatinine concentration. Multivariate logistic regression analysis found that baseline e-GFR and baseline hemoglobin were independent predictors for Contrast induced nephropathy. Conclusion: The overall incidence of Contrast induced nephropathy after coronary intervention in this study is high. Patients with both preexisting renal insufficiency and anemia were at high risk of Contrast induced nephropathy. DOI: http://dx.doi.org/10.3126/njh.v11i1.10975 Nepalese Heart Journal 2014;11(1): 3-11

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