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Published on: April 18, 2013
Association between Systolic Pulmonary Artery Pressure and Contrast-Induced Nephropathy in Patients with ST-Segment
Mehmet Nail Bilen1, Önder Demiröz2, İlyas Çetin1
1Department of Cardiology, Basaksehir Cam and Sakura City Hospital, University of Health Sciences.
Insights
High systolic pulmonary artery pressure (SPAP) is an independent predictor of contrast-induced nephropathy (CIN) in ST-segment elevation myocardial infarction (STEMI) patients. Echocardiography-derived SPAP can help predict CIN risk.
Area of Science:
- Cardiology
- Nephrology
- Medical Imaging
Background:
- Contrast-induced nephropathy (CIN) is a significant complication following percutaneous coronary intervention in ST-segment elevation myocardial infarction (STEMI) patients.
- Identifying patients at high risk for CIN is crucial for implementing preventive strategies.
Purpose of the Study:
- To investigate the association between elevated systolic pulmonary artery pressure (SPAP) and the risk of developing CIN in STEMI patients undergoing primary percutaneous coronary intervention.
- To determine if SPAP is an independent predictor of CIN in this patient population.
Main Methods:
- A cohort of 213 STEMI patients undergoing primary percutaneous coronary intervention was analyzed.
- Patients were stratified into CIN (+) and CIN (-) groups.
- Systolic pulmonary artery pressure (SPAP) was measured via echocardiography upon admission; demographic data, laboratory findings, and risk factors were compared.
Main Results:
- 33 patients (15.5%) developed CIN.
- Elevated SPAP (OR = 1.295, p < 0.001) and diabetes (OR = 1.241, p = 0.013) were independent predictors of CIN.
- An SPAP cutoff of 31.5 mmHg demonstrated 91.0% sensitivity and 90.0% specificity for predicting CIN (p < 0.001).
Conclusions:
- Systolic pulmonary artery pressure (SPAP) measured by echocardiography is a valuable and independent predictor of CIN in STEMI patients.
- The ease of SPAP calculation makes it a practical tool for early CIN risk assessment in STEMI patients.
Introduction:
The objective of this study was to examine whether there is an elevated risk of developing contrast induced nephropathy (CIN) in patients with high systolic pulmonary artery pressure (SPAP) in ST-segment elevation myocardial infarction (STEMI).
Methods:
A total of 213 patients diagnosed with STEMI and who underwent primary percutaneous coronary intervention were enrolled in the study. The patients were stratified into two groups based on the presence of CIN. Comparisons between these groups included an assessment of demographic characteristics, laboratory findings, and risk factors. SPAP was calculated for each patient upon admission through echocardiography, and subsequent comparisons were performed between the groups.
Results:
The distribution of the study population was as follows: 33 (15.5%) were CIN(+) and 180 (84.5%) were CIN(-). SPAP [odds ratio (OR) = 1.295, 95% confidence interval (CI): 1.157-1.451, p < 0.001], and diabetes (OR = 1.241, 95% CI: 1.194-1.287, p = 0.013) were identified as independent factors associated with CIN development. In receiver operating characteristic curve analysis, SPAP above a cut-off level of 31.5 mmHg could determine the presence of CIN with a sensitivity of 91.0% and specificity of 90.0% (p < 0.001).
Conclusions:
SPAP on echocardiography is an independent predictor of the development of CIN in patients with STEMI. Its ease of calculation renders it a valuable tool for predicting CIN among STEMI patients.
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