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R2CHADS2 Score: An Effective Risk Stratification Tool for Contrast-Induced Nephropathy and Cardiovascular Outcomes in

Yusuf Bozkurt Şahin1, Emrullah Kızıltunç2, Mustafa Candemir2

  • 1Department of Cardiology, Etlik City Hospital, Ankara, Turkey.

Angiology
|October 25, 2025
PubMed

Insights

The R2CHADS2 score effectively predicts contrast-induced nephropathy (CIN) and major adverse cardiovascular events (MACE) in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). Higher scores indicate increased risk for these serious complications.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Contrast-induced nephropathy (CIN) is a significant complication post-percutaneous coronary intervention (PCI).
  • The R2CHADS2 score, initially for thromboembolic risk, is now explored for predicting CIN and MACE.
  • ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI (pPCI) are a vulnerable population.

Purpose of the Study:

  • To assess the R2CHADS2 score's predictive capability for CIN in STEMI patients undergoing pPCI.
  • To evaluate the R2CHADS2 score's utility in predicting long-term MACE in this patient cohort.

Main Methods:

  • Retrospective analysis of 1204 STEMI patients undergoing pPCI.
  • Categorization of patients into low, moderate, and high-risk groups based on R2CHADS2 scores.
  • Comparison of CIN incidence and MACE rates across the risk groups.

Main Results:

  • CIN incidence was substantially higher in the high-risk R2CHADS2 group (37.1%) compared to moderate (13.6%) and low-risk (5.5%) groups.
  • Hemodialysis was more frequently required in the high-risk group (14.3%).
  • MACE rates were significantly elevated in the high-risk group (49.3%) versus moderate (22.1%) and low-risk (12.9%) groups.

Conclusions:

  • The R2CHADS2 score demonstrates significant predictive value for CIN in STEMI patients undergoing pPCI.
  • The R2CHADS2 score is also a reliable predictor of adverse cardiovascular outcomes, including MACE, in this population.
  • Risk stratification using the R2CHADS2 score can aid in identifying high-risk STEMI patients for closer monitoring and potential intervention.

Keywords:
R2CHADS2 scorecardiovascular outcomescontrast-induced nephropathymyocardial infarction

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