Author + information
- Liu Yuanhui,
- Yong Liu,
- Ji-yan Chen and
- Ning Tan
Contrast-induced nephropathy (CIN) is a common complication in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), and may cause increased morbidity and mortality. We aimed to evaluate the predictive value of Canada Acute Coronary Syndrome (C-ACS) risk score for CIN in STEMI patients before primary PCI, allowing pre-procedural decisions regarding prevention therapy for CIN.
A total of 394 consecutive patients with STEMI undergoing primary PCI enrolled in this study. The study patients were divided into 3 groups according to their C-ACS scores: Group 1, score 0; Group 2, score 1; and Group 3, score ≥2. The primary outcomes were the development of CIN and major clinical adverse events (MACEs).
Overall, 33 patients (8.4%) developed CIN. Patients with high C-ACS risk scores were more likely to develop CIN (2.8%, 10.3%, 26.4% for C-ACS score 0; 1; ≥2, respectively, p< 0.001), as well with the in-hospital death and MACEs. After adjusting for potential confounding predictors, C-ACS risk scores remained significantly associated with CIN (OR=2.87, 95%CI, 1.78-4.63, p < 0.001). ROC showed that C-ACS risk scores has good predictive values for CIN, in-hospital morality, MACEs and long-term mortality (C statistic=0.751, 0.712, 0.628, respectively). In addition, patients with high C-ACS risk scores exhibited a worse survival rate than patients with low risk scores (Death, p=0.02; MACEs, p=0.006). Furthermore, the C-ACS risk score was independently associated with the long-term MACEs (hazard ratio =1.30, 95% CI=1.04-1.64, p=0.022).
C-ACS risk score can be simply used to predict CIN and to stratify patients for poor clinical outcomes both in the short- and long-term follow-up in patients with STEMI before primary PCI.