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Predictive value of plasma volume status for contrast-induced nephropathy in patients with heart failure undergoing

Chen He1, Sicheng Zhang2, Haoming He2

  • 1Department of Geriatric Medicine, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Key Laboratory of Geriatrics, Fujian Provincial Center for Geriatrics, Fuzhou, 350001, China.

ESC Heart Failure
|October 27, 2021
PubMed

Insights

Plasma volume status (PVS) can predict contrast-induced nephropathy (CIN) in heart failure patients undergoing percutaneous coronary intervention (PCI). Pre-procedural Kaplan-Hakim estimated PVS (KH-ePVS) greater than 0.04 is an independent risk factor for CIN.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Imaging

Background:

  • Contrast-induced nephropathy (CIN) is a frequent complication following coronary procedures, particularly in heart failure patients.
  • Plasma volume expansion is associated with a worse prognosis in heart failure patients.

Purpose of the Study:

  • To investigate the predictive utility of calculated plasma volume status (PVS) for CIN in heart failure patients undergoing elective percutaneous coronary intervention (PCI).

Main Methods:

  • 441 heart failure patients undergoing elective PCI were analyzed.
  • Pre-procedural plasma volume status was estimated using Duarte's formula (Duarte-ePVS) and Kaplan-Hakim formula (KH-ePVS).
  • CIN was defined as an increase in serum creatinine ≥0.5 mg/dL or ≥25% within 48 hours of contrast exposure.

Main Results:

  • 28 patients (6.3%) developed CIN.
  • The optimal cutoff for KH-ePVS to predict CIN was 0.04 (sensitivity 64.5%, specificity 75.5%).
  • Adjusted analysis revealed KH-ePVS > 0.04 as a significant independent risk factor for CIN (OR 2.685, P=0.047).

Conclusions:

  • Pre-procedural KH-ePVS is a valuable independent predictor of CIN in heart failure patients undergoing elective PCI.
  • A KH-ePVS cutoff of 0.04 effectively identifies patients at higher risk for CIN.
Abstract

Keywords:
Contrast-induced nephropathyElective percutaneous coronary interventionHeart failurePlasma volume status

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