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Contrast Media Volume to Creatinine Clearance Ratio in Predicting Nephropathy in Patients Undergoing Percutaneous
Yabin Nie1, Limei Fan2, Qi Song1
1Department of Cardiovascular Medicine, Jingjiang People's Hospital, Jiangsu Province, China.
Insights
The contrast media volume to creatinine clearance ratio (V/CrCl) reliably predicts contrast-induced nephropathy (CIN) risk after percutaneous coronary intervention (PCI). This ratio is an independent predictor, aiding in patient risk stratification for PCI procedures.
Area of Science:
- Cardiology
- Nephrology
- Radiology
Background:
- Contrast-induced nephropathy (CIN) is a significant complication following percutaneous coronary intervention (PCI).
- Previous studies on the predictive value of the contrast media volume to creatinine clearance ratio (V/CrCl) for CIN have yielded conflicting results.
- A standardized approach to V/CrCl assessment for CIN prediction is lacking.
Approach:
- A systematic review and meta-analysis were conducted, searching PubMed, Embase, and Cochrane Library for studies published up to November 2020.
- Six studies, encompassing 8 datasets and 16,899 patients, were included in the analysis.
- Odds ratios (ORs) and 95% confidence intervals (CIs) were used to examine the optimal cut-off points of V/CrCl for predicting CIN, employing a random-effect model.
Key Points:
- The V/CrCl was significantly associated with CIN across the included studies (OR = 2.67).
- This association was consistent in both Asian (OR = 2.13) and European (OR = 3.87) populations.
- V/CrCl demonstrated predictive value in both prospective (OR = 2.16) and retrospective (OR = 3.31) cohort studies, with robust sensitivity analysis results.
Conclusions:
- The V/CrCl is an independent predictor of CIN in patients undergoing PCI.
- This ratio can be considered a reliable tool for assessing the risk of developing CIN.
- Further research may focus on establishing optimal V/CrCl cut-off values for diverse patient populations and clinical settings.
Abstract:
The studies investigated the predictive value of the contrast media volume to creatinine clearance ratio (V/CrCl) for contrast-induced nephropathy (CIN) after a percutaneous coronary intervention (PCI) showed conflicting results and different cut-off values. The objective is to evaluate V/CrCl in the prediction of CIN after PCI. PubMed, Embase, and the Cochrane library were searched for eligible studies published from inception to November 2020. The optimal cut-off points of V/CrCl for predicting CIN were examined using odds ratios (ORs) and 95% confidence intervals (CIs). The random-effect model was used for analyses. Six studies (8 datasets, 16 899 patients) were included. V/CrCl was associated with CIN (OR = 2.67, 95% CI: 1.88-3.78, P < .001; I2 = 79.3%, Pheterogeneity < .001). V/CrCl was associated with CIN in Asians (OR = 2.13, 95% CI: 1.52-2.98, P = .022; I2 = 68.8%, Pheterogeneity < .001) and Europeans (OR = 3.87, 95% CI: 1.77-8.45, P < .001; I2 = 85.1%, Pheterogeneity = .001). The association between V/CrCl and CIN was observed in the prospective cohort studies (OR = 2.16, 95% CI: 1.42-3.29, P = .009; I2 = 78.9%, Pheterogeneity < .001) and retrospective cohort studies (OR = 3.31, 95% CI: 1.82-6.02, P < .001; I2 = 80.6%, Pheterogeneity < .001). The sensitivity analysis showed the results were robust. V/CrCl is independently associated with an increased risk of CIN. V/CrCl could be considered a reliable predictor for the development of CIN in patients undergoing PCI.
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