Comparison of the Performance of the NCDR CathPCI Score and Mehran Score to Predict Acute Kidney Injury...

Area of Science:

• Cardiology
• Nephrology
• Medical Informatics

Background:

• Acute kidney injury (AKI) is a significant complication following percutaneous coronary intervention (PCI).
• Predictive models for post-PCI AKI, such as the NCDR CathPCI score and the Mehran score, require comparative validation.
• A lack of direct comparison between these models, particularly in distinct patient cohorts (acute coronary syndrome vs. non-acute coronary syndrome), necessitates further investigation.

Purpose of the Study:

• To compare the predictive performance of the National Cardiovascular Data Registry (NCDR) CathPCI score and the Mehran score for acute kidney injury (AKI) post-percutaneous coronary intervention (PCI).
• To evaluate the efficacy of these models in patients with and without acute coronary syndrome (ACS).

Main Methods:

• A retrospective analysis of 1,507 patients undergoing PCI between July 2015 and December 2017.
• Exclusion criteria included lack of pre-/post-PCI creatinine, dialysis at PCI, or missing data for scoring models.
• Area under the receiver-operating characteristic curve (AUROC) was used to assess the performance of both predictive scores.

Main Results:

• In non-ACS patients, the Mehran score demonstrated superior performance (AUROC 0.75) compared to the NCDR CathPCI score (AUROC 0.68, p=0.014).
• The Mehran score achieved 86% sensitivity (≥2) and 83% specificity (≥3) in non-ACS patients, whereas the NCDR CathPCI score failed to predict AKI risk (p=0.78).
• In ACS patients, the NCDR CathPCI score outperformed the Mehran score (AUROC 0.79 vs. 0.74, p=0.019).

Conclusions:

• The choice of AKI prediction model post-PCI should be tailored to the patient population.
• The Mehran score is more effective for predicting AKI in non-ACS patients.
• The NCDR CathPCI score demonstrates better predictive accuracy for AKI in ACS patients.