Author + information
- Pei–Hsiu Huang,
- Gustavo N. Araújo,
- Usha S. Govindarajulu,
- Marco Wainstein,
- Frederic Resnic and
- James McCabe
Contrast–induced nephropathy (CIN) is independently associated with mortality following percutaneous coronary intervention (PCI). Multiple prediction models for the development of CIN have been published using discrepant outcome definitions. We sought to compare two CIN risk prediction models in a validation cohort using a consensus definition.
We analyzed 5,818 patients who underwent PCI at our hospital from January 2005 to June 2012. The primary outcome was the development of CIN, defined as increase in serum creatinine of ≥0.3 mg/dl or a relative increase of ≥50% from baseline or a new requirement for dialysis (AKIN Stage 1 or greater) after PCI. Receiver operator characteristic (ROC) curves were used to evaluate the discriminatory power of the Mehran and William Beaumont Hospital (WBH) prediction models.
The mean age of our cohort was 68 ± 12 years and 36% had diabetes. The mean baseline creatinine was 1.2 ± 0.53 mg/dl (eGFR 73 ± 27 ml/min). The index PCI was elective or urgent in 87.6% of cases. The mean contrast volume used was 212 ± 92 ml. CIN occurred in 508 patients (8.7%). The Mehran risk score demonstrated better discrimination than the WBH risk score (c statistics 0.82 vs 0.73 respectively; Figure). Mortality at 30 days was 225% higher among patients with CIN as compared to those without (1.8% vs 0.8% p = 0.03).
In an independent validation cohort, the Mehran risk model demonstrates greater discriminatory power than the WBH model in predicting the incidence of CIN.
West, Room 2005
Sunday, March 10, 2013, 8:15 a.m.–8:25 a.m.
Session Title: Complicated Patients and Complex PCI
Abstract Category: 43. TCT@ACC–i2: Complex Patients, Diabetes, Renal Insufficiency
Presentation Number: 2904–3
- 2013 American College of Cardiology Foundation