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Risk factors of contrast induced nephropathy in patients with acute coronary syndromes
Affiliations- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Krakow Center of Invasive Cardiology, Electrotherapy and Angiology, Kraków, Poland
- Center of Invasive Cardiology, Electrotherapy and Angiology in Nowy Sącz, Nowy Sącz, Poland
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Abstract
BACKGROUND: Patients with acute coronary syndromes (ACS) are at high risk of contrast-induced nephropathy (CIN), which is associated with prolonged hospitalization and higher morbidity and mortality after angiographic procedures. The occurrence of CIN is regarded as a transient and reversible condition. However, the persistence of CIN until hospital discharge in patients with ACS has not been thoroughly analyzed.
AIMS: Our aim was to analyze CIN persistent until hospital discharge in contemporary ACS population referred to invasive diagnostics and treatment.
METHODS: A total of 2,638 consecutive patients with ACS were included in a prospective registry. The occurrence of CIN was defined as a 25% increase in serum creatinine from baseline or a 0.5 mg/dl (44 µmol/l) increase in absolute value.
RESULTS: Criteria of CIN at hospital discharge were met in 10.7% of patients. Immediate percutaneous coronary intervention (PCI) after angiography (67% of patients) was associated with higher rates of CIN compared to patients referring to other treatment strategies (P <0.001). The logistic regression model showed that anemia at baseline (8.7% of patients) was the independent predictor of CIN, which occurred in 17.9% of anemic patients and 10% of patients without anemia (P <0.001). Also, ST-segment elevation myocardial infarction (STEMI) presentation and immediate PCI were independent predictors of CIN.
CONCLUSIONS: Despite intravenous fluid administration during the hospital stay, CIN persisted until hospital discharge in more than 10% of patients with ACS. Anemia at baseline, STEMI presentation and immediate PCI strategy were independent predictors of CIN. Thus, preventive actions should be specially aimed at those groups of patients.
Abstract
BACKGROUND: Patients with acute coronary syndromes (ACS) are at high risk of contrast-induced nephropathy (CIN), which is associated with prolonged hospitalization and higher morbidity and mortality after angiographic procedures. The occurrence of CIN is regarded as a transient and reversible condition. However, the persistence of CIN until hospital discharge in patients with ACS has not been thoroughly analyzed.
AIMS: Our aim was to analyze CIN persistent until hospital discharge in contemporary ACS population referred to invasive diagnostics and treatment.
METHODS: A total of 2,638 consecutive patients with ACS were included in a prospective registry. The occurrence of CIN was defined as a 25% increase in serum creatinine from baseline or a 0.5 mg/dl (44 µmol/l) increase in absolute value.
RESULTS: Criteria of CIN at hospital discharge were met in 10.7% of patients. Immediate percutaneous coronary intervention (PCI) after angiography (67% of patients) was associated with higher rates of CIN compared to patients referring to other treatment strategies (P <0.001). The logistic regression model showed that anemia at baseline (8.7% of patients) was the independent predictor of CIN, which occurred in 17.9% of anemic patients and 10% of patients without anemia (P <0.001). Also, ST-segment elevation myocardial infarction (STEMI) presentation and immediate PCI were independent predictors of CIN.
CONCLUSIONS: Despite intravenous fluid administration during the hospital stay, CIN persisted until hospital discharge in more than 10% of patients with ACS. Anemia at baseline, STEMI presentation and immediate PCI strategy were independent predictors of CIN. Thus, preventive actions should be specially aimed at those groups of patients.
Keywords
contrast-induced nephropathy, acute coronary syndrome, percutaneous coronary intervention, anemia
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About this articleTitle
Risk factors of contrast induced nephropathy in patients with acute coronary syndromes
Journal
Kardiologia Polska (Polish Heart Journal)
Issue
Article type
Original article
Published online
2022-05-06
Page views
59
Article views/downloads
26
DOI
10.33963/KP.a2022.0123
Pubmed
Keywords
contrast-induced nephropathy
acute coronary syndrome
percutaneous coronary intervention
anemia
Authors
Tomasz Rakowski
Artur Dziewierz
Michał Węgiel
Zbigniew Siudak
Wojciech Zasada
Jacek Jąkała
Dominika Dykla
Jerzy Matysek
Andrzej Surdacki
Stanisław Bartuś
Dariusz Dudek
Roman Wojdyła
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