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H2FPEF Score and Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome Undergoing Percutaneous

Nail Burak Ozbeyaz1, Gokhan Gokalp1, Engin Algul2

  • 1Pursaklar State Hospital, 37511Department of Cardiology Clinic, Ankara, Turkey.

Angiology
|May 3, 2022
PubMed

Insights

The H2FPEF score can predict contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Higher scores indicate increased risk, aiding early intervention for this common complication.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Diagnostics

Background:

  • Contrast-induced nephropathy (CIN) is a frequent complication following coronary angiography and percutaneous coronary intervention (PCI).
  • Predictive tools for CIN are crucial for patient management and risk stratification.
  • The H2FPEF score, initially developed for heart failure with preserved ejection fraction, has potential for other cardiovascular risk assessments.

Purpose of the Study:

  • To investigate the association between the H2FPEF score and the development of CIN in patients undergoing PCI for acute coronary syndrome (ACS).
  • To determine if the H2FPEF score is an independent predictor of CIN.
  • To establish a predictive cutoff value for the H2FPEF score for CIN development.

Main Methods:

  • Retrospective analysis of 1346 patients who underwent PCI for ACS between December 2018 and January 2021.
  • Calculation of H2FPEF scores for all included patients.
  • Statistical analysis including correlation and receiver operating characteristic (ROC) curve analysis to assess the predictive value of the H2FPEF score for CIN.

Main Results:

  • Patients who developed CIN had significantly higher H2FPEF scores compared to those who did not (4.10 ± 1.92 vs 2.28 ± 1.56, P < .001).
  • The H2FPEF score was identified as an independent risk factor for CIN (OR 1.633, P < .001), alongside age, diabetes, pulmonary hypertension, and infarct artery location.
  • A strong positive correlation was observed between CIN and H2FPEF score (rpb = .376, P < .001).
  • The optimal H2FPEF score cutoff for predicting CIN was 2.5, with 79.8% sensitivity and 64.1% specificity.

Conclusions:

  • The H2FPEF score demonstrates significant potential as a predictive tool for contrast-induced nephropathy in ACS patients undergoing PCI.
  • Utilizing the H2FPEF score can aid clinicians in identifying high-risk individuals, potentially enabling preventative strategies.
  • Further prospective studies are warranted to validate these findings and integrate the H2FPEF score into clinical practice for CIN prevention.

Keywords:
H2FPEF scoreacute coronary syndromecontrast-induced nephropathypercutaneous coronary intervention

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