Author + information
- Dimitrios Tziakas,
- George Chalikias,
- Levent Serif,
- Adina Thomaidis,
- Petros Kikas,
- Ioannis Drosos and
- Stavros Konstantinides
Background: Contrast-induced nephropathy (CIN) is a frequent, potentially lethal complication of percutaneous coronary interventions (PCI). We prospectively validated the diagnostic performance of all published risk scores in a cohort of patients undergoing PCI.
Methods: We enrolled 602 consecutive patients (81% men, of mean age 63±10 years) treated with elective or urgent PCI. We calculated for each patient, risk scores for 12 different risk models (Bartholemew et al, 2004; Chen et al, 2014; Fu et al, 2012; Gao et al, 2014; Ghani et al, 2009; Gurm et al, 2013; Liu et al, 2015; Mehran et al, 2004; Maioli et al, 2010; Marenzi et al, 2004; Tziakas et al, 2013; Victor et al, 2014). We then calculated the predictive accuracy of each risk model using ROC analysis. CIN was defined as an increase, compared to baseline, of serum creatinine by ≥ 25%, or by ≥0.5mg/dl, 48 hours after PCI.
Results: CIN occurred in 8.3% of the study population. The predictive accuracy (AUC) of all risk scores ranged from 0.494 (the lowest) to 0.686 (the highest). Models with at least moderate predictive value (>0.600) were : Maioli et al, 0.686, 95%CI 0.610 to 0.762; Fu et al, 0.664, 95% 0.590 to 0.737; Mehran et al, 0.657, 95%CI 0.589 to 0.724; Bartholomew et al, 0.637, 95%CI 0.561 to 0.713; Victor et al, 0.632 95%CI 0.556 to 0.708; Marenzi et al, 0.625 95%CI 0.544 to 0.706; and Tziakas et al, 0.600, 95%CI 0.527 to 0.673. ROC curve comparison showed that the predictive accuracy of these models was not significantly different.
Conclusions: A prospective cohort study among patients undergoing elective or urgent PCI in a real clinical setting showed that among 12 different published risk models for CIN prediction the Maioli et al (2010), Fu et al (2012), Mehran et al (2004), Bartholomew et al (2004), Victor et al (2014), Marenzi et al (2004) and Tziakas et al (2013) risk models were the best to predict CIN.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Complexity and Complications
Abstract Category: 26. Interventional Cardiology: Vascular Access and Complications
Presentation Number: 1285-167
- 2017 American College of Cardiology Foundation