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Risk factors of contrast-induced nephropathy in patients with STEMI and pump failure undergoing percutaneous coronary

Hongwu Chen1,2, Xiaofan Yu1,2, Likun Ma1,2

  • 1Department of Cardiology, Division of Life Sciences and Medicine, The First Affiliated Hospital of the University of Science and Technology of China (USTC), USTC, Hefei, Anhui 230001, P.R. China.

Experimental and Therapeutic Medicine
|January 18, 2021
PubMed

Insights

The Killip grade is a risk predictor for contrast-induced nephropathy (CIN) in ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). Higher Killip grades correlate with increased CIN risk, especially after primary PCI.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Contrast-induced nephropathy (CIN) is a significant complication in patients with ST-elevation myocardial infarction (STEMI).
  • Risk factors for CIN in STEMI patients undergoing percutaneous coronary intervention (PCI) are not fully understood.
  • Pump failure, indicated by Killip classification, is a critical factor in STEMI prognosis.

Purpose of the Study:

  • To investigate the association between Killip grade and the development of CIN.
  • To assess CIN risk in STEMI patients with pump failure undergoing PCI.
  • To compare CIN rates between primary PCI (PPCI) and elective PCI (EPCI) in relation to Killip grade.

Main Methods:

  • Retrospective analysis of 7,471 STEMI patients with pump failure from a combined Chinese Society of Cardiology and American Heart Association database.
  • Patients were stratified by Killip grade (II, III, IV) and PCI type (PPCI vs. EPCI).
  • Logistic regression analysis was used to identify risk predictors for post-PCI CIN.

Main Results:

  • A statistically significant difference in CIN rates was observed for Killip grade II patients undergoing PPCI compared to EPCI.
  • No significant difference in CIN rates was found between PPCI and EPCI for Killip grades III and IV.
  • Killip classification emerged as a significant risk predictor for post-PCI CIN.

Conclusions:

  • A positive association exists between higher Killip grades and the risk of post-PCI CIN in STEMI patients with pump failure.
  • STEMI patients with Killip grade II pump failure face a higher risk of CIN after PPCI compared to EPCI.
  • Further prospective studies are warranted to validate these findings.

Keywords:
Killip gradeST-elevation myocardial infarctioncontrast-induced nephropathyprimary percutaneous coronary interventionpump failure

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