Author + information
- Matteo Tebaldi,
- Marco Valgimigli,
- Gianluca Campo,
- Stefania Gambetti,
- Laura Bristot,
- Monia Monti and
- Roberto Ferrari
Contrast induced acute kidney injury (CI–AKI) is a serious complication of coronary catheterization which increases morbidity and mortality. The identification of a reliable biomarker that allows for early diagnosis of CI–AKI may optimize clinical management of patients.
From June 2010 to October 2010, 154 patients undergoing coronary catheterization were enrolled. The serum creatinine was measured at baseline, 24 and 48 hours whereas urinary creatinine and urinary NGAL were measured at baseline, and then at 3, 6, 24, 48 hours. CI–AKI was defined as creatinine increase ≥0.3mg/dL and ≥ 0.5mg/dL at48 hours.
NGAL showed a poor positive but a very high negative predictive value, which peaked at 98% at the 3–hour time point for CI–AKI≥0.3 and it was as high as 100% for CI–AKI ≥0.5. Normalization of NGAL values for urinary creatinine resulted in a trends towards improving the overall diagnostic performance. When entered into the model containing the Mehran risk score, NGAL (ng/mg creatinine) values obtained at 3 (RR: 1.029; p=0.029) or 6 hours (RR: 1.043; p=0.0018) remained significantly associated to the occurrence of CI–AKI≥0.3. The adaptive index model identified NGAL at 3 hours as the best CI–AKI predictor on top of the Mehran risk score.
The use of NGAL is promising biomarker for the early identification of patients with a higher probability to develop CI–AKI.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Complex Patients, Diabetes and Renal Insufficiency
Abstract Category: 43. TCT@ACC–i2: Complex Patients, Diabetes, Renal Insufficiency
Presentation Number: 2106–221
- 2013 American College of Cardiology Foundation