Related Experiment Video
Updated: Mar 29, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Is atrial fibrillation a risk factor for contrast-induced nephropathy in patients with ST-elevation myocardial
Mehmet Ballı1, Hakan Taşolar2, Mustafa Çetin2
1Mersin State Hospital, Department of Cardiology, Mersin, Turkey.
Insights
Atrial fibrillation (AF) significantly increases the risk of contrast-induced nephropathy (CIN) in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI). Identifying AF is crucial for preventing CIN in these high-risk individuals.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Contrast-induced nephropathy (CIN) is a significant complication in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI).
- Atrial fibrillation (AF) is increasingly recognized as a potential contributor to kidney dysfunction.
- The interplay between AF and CIN in STEMI patients requires further investigation.
Purpose of the Study:
- To investigate the association between atrial fibrillation (AF) and the development of contrast-induced nephropathy (CIN).
- To identify risk factors for CIN in patients with STEMI undergoing PPCI.
Main Methods:
- A cohort of 650 STEMI patients treated with PPCI was analyzed.
- Patients were classified as having AF if they did not achieve sinus rhythm within 48 hours of admission.
- CIN was defined by a significant increase in serum creatinine levels within 72 hours post-contrast exposure.
Main Results:
- Multivariate logistic regression revealed that AF is an independent predictor of CIN (OR, 6.945; 95% CI, 2.789-17.293; p<0.001).
- Reduced estimated glomerular filtration rate (eGFR) and left ventricular ejection fraction (LVEF) were also independently associated with increased CIN risk.
- Patients with CIN showed significantly lower eGFR and LVEF, and higher prevalence of AF compared to those without CIN.
Conclusions:
- Atrial fibrillation (AF) is a significant independent risk factor for contrast-induced nephropathy (CIN) in STEMI patients undergoing PPCI.
- Identifying patients with AF is critical for proactive CIN prevention strategies.
- CIN development is multifactorial, with AF emerging as a key modifiable risk factor alongside traditional ones like eGFR and LVEF.
Background:
Contrast-induced nephropathy (CIN) is an iatrogenic problem in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Atrial fibrillation (AF) may also contribute to impaired kidney function. Several factors may contribute to the development of CIN. In patients with STEMI, concomitant AF is associated with higher in-hospital/follow-up mortality and morbidity. Therefore, we aimed to investigate the relationship between AF and CIN developments.
Methods:
In this study, 650 consecutive STEMI patients treated with PPCI were enrolled. Patients with AF at admission who did not achieve a sinus rhythm during 48h after hospitalization were defined as AF patients. CIN was defined by an increase in serum creatinine by >25% or 0.5mg/dL within 72h following contrast media exposure.
Results:
Our patients were divided into two groups based on whether they had AF, and although warfarin usage was different, the other parameters were similar between the groups. When our patients were grouped according to CIN development [group 1: CIN (+), group 2: CIN (-)], creatinine levels prior to PPCI (p=0.020), estimated glomerular filtration rate (eGFR) prior to PPCI (p<0.001), left ventricular ejection fraction (LVEF) (p=0.011), AF (p<0.001), and warfarin usage (p=0.016) were different between the two groups. We also performed multivariate logistic regression analyses and found that AF [odds ratio (OR), 6.945; 95% confidence interval (CI), 2.789-17.293; p<0.001], eGFR (OR, 0.973; 95% CI, 0.957-0.989; p=0.001), and LVEF (OR, 0.963; 95% CI, 0.935-0.991; p=0.010) independently predicted CIN development in patients with STEMI.
Conclusions:
The risk factors for CIN are multifactorial and identifying high-risk patients is the most important step for prevention. In addition to traditional risk factors, AF can contribute to CIN development in patients with STEMI.
More Related Videos
Related Concept Videos
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:30Acute Coronary Syndrome I: Introduction
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:26Cardiac Catheterization IV: Nursing Management
01:30Acute Coronary Syndrome III: Diagnostic Studies