Contrast medium volume to estimated glomerular filtration rate ratio as a predictor of contrast-induced nephropathy developing after elective percutaneous coronary intervention

Summary Background Contrast-induced nephropathy (CIN) has been recognized as a serious complication of diagnostic coronary angiography and percutaneous coronary intervention (PCI), and has been associated with prolonged hospitalization and adverse clinical outcomes. A key step to minimize the risk f...

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Published in:Journal of cardiology 2009-10, Vol.54 (2), p.214-220
Main Authors: Nozue, Tsuyoshi, MD, Michishita, Ichiro, MD, FJCC, Iwaki, Taku, MD, Mizuguchi, Ichiro, MD, Miura, Motohiro, MD
Format: Article
Language:English
Subjects:
Adult
Aged
Angina Pectoris - diagnostic imaging
Angina Pectoris - therapy
Angioplasty
Cardiovascular
Contrast Media - administration & dosage
Contrast Media - adverse effects
Contrast medium
Contrast-induced nephropathy
Coronary Angiography
Female
Glomerular Filtration Rate
Humans
Kidney Diseases - chemically induced
Kidney Diseases - diagnosis
Male
Percutaneous coronary intervention
Predictive Value of Tests
Regression Analysis
Retrospective Studies
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Summary:Summary Background Contrast-induced nephropathy (CIN) has been recognized as a serious complication of diagnostic coronary angiography and percutaneous coronary intervention (PCI), and has been associated with prolonged hospitalization and adverse clinical outcomes. A key step to minimize the risk for developing CIN is to identify patients at risk for CIN. Methods and results We retrospectively investigated clinical factors associated with the development of CIN in 60 stable angina patients who had undergone elective PCI. The frequency of CIN was 13% (8/60). There were neither any significant differences in age, gender, baseline serum creatinine or hemoglobin levels, nor in the rate of diabetes mellitus between the CIN and the non-CIN group. However, the estimated glomerular filtration rate (eGFR) was significantly lower (40.4 ± 11.4 mL/min/1.73 m2 vs. 57.4 ± 22.6 mL/min/1.73 m2 , p = 0.044), and number of treated vessels (1.5 ± 0.8 vs. 1.2 ± 0.4, p = 0.039) and stents used (2.1 ± 0.6 vs. 1.4 ± 0.6, p = 0.007) were significantly higher in the CIN group. In addition, the amount of contrast medium was significantly larger (272 ± 37 mL vs. 201 ± 62 mL, p = 0.003) and the contrast medium volume (CMV) to eGFR ratio (CMV/eGFR) was significantly greater (7.4 ± 2.9 vs. 4.0 ± 2.0, p = 0.0001) in the CIN group. Stepwise regression analysis showed that the CMV/eGFR ratio was a significant independent predictor of CIN ( p = 0.035). At a cut-off point of >5.1, the CMV/eGFR ratio exhibited 87.5% sensitivity and 74.5% specificity for detecting CIN. Conclusion The CMV/eGFR ratio could be a useful predictor of CIN developing after elective PCI.
ISSN:0914-5087
1876-4738
DOI:10.1016/j.jjcc.2009.05.008