Author + information
- Yub Raj Sedhai,
- Santosh Timalsina,
- Ankush Asija,
- Tatvam Choksi,
- Waseem Ahangar,
- David Gevorgyan,
- Reshma Golamari,
- Madhura Borikar,
- Tawseef Dar,
- Joseph Alukal and
- Jose Missri
Background: Many risk prediction scores have been previously proposed to predict contrast-induced nephropathy (CIN). However, popular scoring systems like Mehran score require clinical, laboratory & procedural data making it complicated to use. CHA2DS2-VASc score is used to predict embolic risk in patients with atrial fibrillation. It requires patient related historical data only. Thus, we investigated if CHA2DS2 VASc score could be used as a predictor of CIN in patients undergoing cardiac catheterization.
Methods: A retrospective chart review of 513 patients who underwent cardiac catheterization from June to December 2014 was performed. Patients with end-stage renal disease (n=38) & patients without pre-procedural serum creatinine (n=57) were excluded. CIN was defined as an increase in serum creatinine by ≥25% or ≥0.5mg/dl from the pre-procedural value within 72 hours of contrast exposure. CHA2DS2-VASc score & Mehran score was calculated for each patient. Receiver operating characteristic curve was obtained & area under the curve (AUC) was calculated for both the scores to see the predictive ability for CIN.
Results: A total of 418 patients (mean age 69.1 ± 13.8, 55% male & 45% female) were included in the study. 16 patients developed CIN with a mean incidence 3.8%. AUC for CHA2DS2-VASc was 0.744 with 95% confidence interval (CI) 0.636- 0.852, P=0.001, optimal cut-off was 2.5, sensitivity 78.9 % & specificity 55.4%. AUC for Mehran score was 0.793, 95% CI 0.646- 0.940, P=0.01, optimal cut-off was 9.5, sensitivity 85.7 % & specificity 71.0%. When compared to Mehran score, CHA2DS2-VASc had similar AUC & sensitivity. Mehran score had a superior specificity.
Conclusions: CHA2DS2-VASc can be used as a potential predictor of CIN in patients undergoing cardiac catheterization. It may be useful clinically as it requires patient related historical data only & is based on a linear equation, which makes it easy to calculate.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: Angiography, Intravascular Imaging and Interventional CT/MR
Abstract Category: 16. Interventional Cardiology: Angiography and Interventional CT/MR
Presentation Number: 1153-123
- 2017 American College of Cardiology Foundation