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Assessing in-hospital mortality and predictors in Patients with contrast-induced nephropathy Following primary
Rajesh Kumar1, Kheraj Mal1, Abiha Urooj1
1National Institute of Cardiovascular Diseases, Karachi, Pakistan.
Insights
Contrast-induced nephropathy (CIN) after primary percutaneous coronary intervention (PCI) is linked to high in-hospital mortality. Inferior wall myocardial infarction with right ventricular infarction, arrhythmias, and pump failure significantly increase this risk.
Area of Science:
- Cardiology
- Nephrology
- Clinical Outcomes Research
Background:
- Contrast-induced nephropathy (CIN) is a frequent complication following primary percutaneous coronary intervention (PCI).
- CIN is associated with a substantial increase in the risk of mortality.
- This study specifically examined in-hospital mortality rates in patients who developed CIN post-primary PCI.
Purpose of the Study:
- To determine the in-hospital mortality rate among patients who developed CIN after primary PCI.
- To identify clinical and demographic predictors associated with in-hospital mortality in this patient group.
Main Methods:
- A descriptive cross-sectional study was conducted on patients who developed CIN after primary PCI.
- CIN was defined by a 25% relative or 0.5 mg/dL absolute increase in serum creatinine within 72 hours post-procedure.
- Binary logistic regression analysis was used to identify predictors of in-hospital mortality.
Main Results:
- The study included 402 patients, with 74.1% males and a mean age of 59.4 years.
- The in-hospital mortality rate was 9.7%.
- Independent predictors of increased mortality included inferior wall myocardial infarction with right ventricular infarction (aOR=3.63), intra-procedure arrhythmias (aOR=5.53), and pump failure (aOR=8.94).
Conclusions:
- Patients developing CIN after primary PCI face a high mortality rate.
- The presence of inferior wall myocardial infarction with right ventricular infarction, intra-procedure arrhythmias, and pump failure significantly elevates the risk of mortality in these patients.
Background:
The contrast-induced nephropathy (CIN) is a common complication of primary percutaneous coronary intervention (PCI) it has been reported to be associated with an increased risk of mortality. The study reported the in-hospital mortality among patients who developed CIN after primary PCI.
Methods:
This descriptive cross-sectional study was conducted on a sample of consecutive who developed CIN after primary PCI at a tertiary care cardiac hospital in Karachi, Pakistan. The CIN was defined as either a relative increase of 25% or an absolute increase of 0.5 mg/dL in post -procedure serum creatinine within 72 hours. The in-hospital mortality status was recorded and clinical and demographic predictors of in-hospital mortality were identified with the help of binary logistic regression analysis.
Results:
In the study sample of 402 patients, 74.1% (298) were male and the mean age of the study sample was 59.4±11.5 years. The in-hospital mortality rate was 9.7% (39). On multivar iable analysis, an increased risk of mortality was found to be independently associated with inferior wall myocardial infarction (IWMI) with right ventricular (RV) infarction, intra-procedure arrhythmias, and pump failure with an adjusted odds ratio of 3.63 [95% CI: 1.31-10.08; p=0.013], 5.53 [95% CI: 1.39-22.06; p=0.015], and 8.94 [95% CI: 3.99-20.02; p<0.001], respectively.
Conclusions:
In conclusion, there is a high rate of mortality for patients who develop CIN after primary PCI, and the risk of mortality is further aggravated by the presence of IWMI with RV infarction, intra-procedure arrhythmias, and pump failure.
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