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Published on: February 2, 2021
Risk Prediction Models for Contrast-associated Acute Kidney Injury After Percutaneous Coronary Intervention: A
Hui Zhang1, Tongtong Chen1, Ning Chen2
1Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.
Insights
This review systematically evaluated risk prediction models for contrast-associated acute kidney injury (CA-AKI) in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). Most models showed moderate predictive ability but had a high risk of bias, limiting clinical utility.
Area of Science:
- Cardiology
- Nephrology
- Medical Informatics
Background:
- Contrast-associated acute kidney injury (CA-AKI) is a significant complication following percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) patients.
- Risk prediction models aim to identify patients at high risk for CA-AKI, enabling targeted preventive strategies.
Conclusions:
- Existing CA-AKI risk prediction models for STEMI patients undergoing PCI demonstrate variable predictive performance but often suffer from a high risk of bias.
- The clinical utility of current models remains uncertain due to methodological limitations.
- Future model development should prioritize robust methodology and explore advanced techniques like machine learning and natural language processing to enhance predictive accuracy and clinical applicability.
Abstract:
The aim of this review was to systematically review published studies on risk prediction models for contrast-associated acute kidney injury (CA-AKI) in patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). We searched PubMed, Embase, Web of Science, Scopus, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Chinese databases from inception to July 1, 2024. The Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS) was used to extract data and The Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to assess the risk of bias and applicability. A total of 2784 publications were retrieved; 16 studies were included. The models' area under the curve (AUC) or C-index ranged from 0.719 to 0.877. Commonly used predictors included age, diabetes, Killip class, and use of intra-aortic balloon pump (IABP). Thirteen studies were determined to be at high risk of bias, while three were unclear, but their applicability was satisfactory. The models' clinical utility was still up for debate. Future development or validation of models should focus on methodology and combine machine learning and natural language processing to analyze data to improve the predictive ability and clinical applicability of models.
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Acute Kidney Injury IV: Diagnostic Studies and Prevention
Acute Kidney Injury V: Interprofessional Care

