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Risk prediction of contrast-induced nephropathy by ACEF score in patients undergoing coronary catheterization
Davide Capodanno1, Margherita Ministeri, Fabio Dipasqua
1aFerrarotto Hospital, University of Catania bETNA Foundation, Catania, Italy.
Insights
The ACEF score effectively predicts contrast-induced nephropathy (CIN) in patients undergoing coronary angiography. Higher ACEF scores correlate with increased CIN risk, aiding in patient stratification.
Area of Science:
- Cardiology
- Nephrology
- Medical Diagnostics
Background:
- Contrast-induced nephropathy (CIN) is a significant complication following coronary angiography.
- Predictive tools are needed to identify patients at high risk for CIN.
- The ACEF score is a scoring system used in cardiovascular medicine.
Purpose of the Study:
- To evaluate the predictive ability of the ACEF score for CIN incidence.
- To assess the association between ACEF score tertiles and CIN development.
- To determine if the ACEF score is an independent predictor of CIN.
Main Methods:
- A cohort of 706 patients undergoing coronary angiography ± PCI was analyzed.
- CIN was defined using narrow (creatinine rise ≥0.5 mg/dl) and broad criteria.
- Statistical analysis included logistic regression and assessment of predictive discrimination (c-statistic).
Main Results:
- The overall incidence of CINnarrow was 5.5% and CINbroad was 13.6%.
- A significant gradient in CIN incidence was observed across ACEF score tertiles (P<0.001 for CINnarrow).
- The ACEF score was an independent predictor of CINnarrow (aOR 1.6, P=0.047) with good discrimination (c-statistic 0.71).
Conclusions:
- The ACEF score is a valuable independent predictor of CIN.
- It can identify patients at higher risk for CIN following coronary procedures.
- The ACEF score aids in risk stratification for CIN.
Aims:
To explore the ability of the ACEF score to predict the incidence of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography with or without percutaneous coronary intervention.
Methods:
A total of 706 patients undergoing coronary angiography ± percutaneous coronary intervention (PCI) between March 2011 and October 2011 were analyzed. CIN using different definitions was termed as CINnarrow (rise in serum creatinine ≥0.5 mg/dl) and CINbroad (rise in serum creatinine ≥0.5 mg/dl and/or ≥25% increase in baseline serum creatinine).
Results:
The mean ACEF score was 1.5 ± 0.6. Overall incidences of CINnarrow and CINbroad were 5.5% and 13.6%, respectively. There was a significant gradient in the incidence of CINnarrow (2.9%, 3.9%, 10.6% in the I, II, and III tertiles, respectively, P < 0.001) and CINbroad (9.1%, 14.2%, 17.9% in the I, II, and III tertiles, respectively, P = 0.021) across increasing ACEF tertiles. The ACEF score was independently associated with the risk of CINnarrow (adjusted odds ratio [OR] 1.6, 95% confidence interval [CI] 1.0-2.7; P = 0.047). Discrimination was more satisfactory when using the ACEF as a predictor of CINnarrow (c-statistic 0.71, 95% 0.63-0.79).
Conclusion:
The ACEF score is an independent and potentially useful predictor of CIN defined as rise in serum creatinine ≥0.5 mg/dl.
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