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Recent reports have suggested that the ratio of contrast volume use to estimated glomerular filtration rate (CVeGFRr) independently predicts contrast–induced nephropathy (CIN) following PCI. Whether this is widely applicable is not clear.
3,825 PCI procedures performed between 12/2010 and 09/2012 in 2 large hospitals in our health system were analyzed. CIN was defined as an absolute increase in serum creatinine ≥0.5 mg/dL or an increase ≥25% from baseline within 72 hours after the administration of contrast medium. Glomerular filtration rate was estimated using modification of diet in renal disease (MDRD) formula. Procedures with missing pre–or postprocedural creatinine or patients on dialysis were excluded (n=276). ACC–NCDR data definitions were used to define variables.
CIN was seen in 279 (7.86%) patients out of 3549 patients following PCI. Female gender, history of prior heart failure, diabetes, cardiogenic shock in the prior 24 hours were noted to be more prevalent in patients who had CIN. After multivariable adjustment with high risk baseline characteristics, CVeGFRr was noted to be an independent predictor of CIN with an odds ratio of 1.73 (1.22–2.44), p=0.002. CVeGFRr >3 was associated with 1.73 increased odds of developing CIN compared to CVeGFRr<3.
In this observational registry, CVeGFRr is a reliable predictor of CIN following PCI. Our analysis provides a strong support for the use of this ratio as a risk–reduction strategy for CIN following PCI.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Acute Coronary Syndrome and Acute Myocardial Infarction
Abstract Category: 40. TCT@ACC–i2: ACS/AMI/Hemodynamic Support
Presentation Number: 2113–263
- 2013 American College of Cardiology Foundation