Risk Factors Associated With Contrast-Induced Nephropathy after Primary Percutaneous Coronary Intervention
Dileep Kumar1, Hussain Liaquat1, Jawaid A Sial1
1Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK.
Insights
Contrast-induced nephropathy (CIN) after primary percutaneous coronary intervention (PCI) affects 13.1% of STEMI patients. Diabetes and high contrast volume increase CIN risk, highlighting key factors for prevention.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Contrast-induced nephropathy (CIN) is a significant complication following primary percutaneous coronary intervention (PCI).
- CIN is linked to higher mortality and morbidity rates in patients with ST-segment elevation myocardial infarction (STEMI).
Purpose of the Study:
- To determine the frequency of CIN after primary PCI in STEMI patients.
- To identify risk factors associated with CIN in this population at a Pakistani tertiary cardiac center.
Main Methods:
- An observational study included 282 STEMI patients undergoing primary PCI.
- Serum creatinine levels were measured at baseline and 48–72 hours post-PCI to define CIN.
- CIN was defined as a 25% or ≥ 0.5 mg/dL increase in creatinine levels.
Main Results:
- The overall incidence of CIN was 13.1% (37 patients).
- Diabetes mellitus (OR 2.3) and increased contrast use >200 mL (OR 3.12) were significantly associated with higher CIN risk.
- The study population comprised 68.4% males with a mean age of 56.4 years; 78.7% were hypertensive and 34% diabetic.
Conclusions:
- CIN is a common complication after primary PCI in STEMI patients.
- Diabetes mellitus and substantial contrast administration are significant risk factors for developing CIN.
- These findings underscore the importance of risk factor management and contrast volume optimization during primary PCI.
Abstract:
Background Contrast-induced nephropathy (CIN) after primary percutaneous coronary intervention (PCI) is associated with increased mortality and morbidity. The aim of this study is to determine the frequency of CIN after primary PCI and its association with risk factors in patients with ST-segment elevation myocardial infarction (STEMI) at a tertiary care cardiac center in Pakistan. Methodology In this observational study, we included 282 patients who presented with STEMI and underwent primary PCI at the National Institute of Cardiovascular Disease, Karachi, Pakistan, from October 2017 to April 2018. The serum creatinine (mg/dL) levels were obtained at baseline and 48 to 72 hours after the primary PCI procedure, and patients with a 25% increase or ≥ 0.5 mg/dL rise in post-procedure creatinine level (after 48 to 72 hour) were categorized for CIN. Results Out of a total sample of 282 patients, 68.4% (193) were males, and the mean age was 56.4 ± 9.1 years. A majority of the patients, 78.7% (222), were hypertensive and 34% (96) were diabetic. The CIN was observed in 13.1% (37) of the patients, and increased risk of CIN was found to be associated with the presence of diabetes mellitus and increased (>200 mL) use of contrast during the procedure, with odds ratios of 2.3 (1.14-4.63) and 3.12 (1.36-7.17), respectively. Conclusions The CIN after PCI is a common complication associated with the presence of diabetes mellitus and the use of an increased amount of contrast during the procedure.
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