A novel risk score model for prediction of contrast-induced nephropathy after emergent percutaneous coronary intervention

Lin, Kaiyang; Zheng, Wenjie; Bei, Wei-jie; Chen, Shiqun; Islam, Sheikh Mohammed Shariful; Liu, Yong; Xue, Lei; Tan, Ning; Chen, Jiyan

doi:10.1016/j.ijcard.2016.12.095

Cited by 39 publications

(41 citation statements)

References 47 publications

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“…The incidence of CI-AKI after pPCI ranges from 11.9 to 17.1% according to previous studies, which is significantly higher than that of elective PCI [19][20][21][22][23]. As with above studies, our study also demonstrated a similar high incidence of 15% in this population, which is strongly associated with blood volume insufficiency, hemodynamic instability and inadequate hydration.…”

Section: Discussionsupporting

confidence: 86%

“…Thus it's crucial to screen the risk factors of CI-AKI in these patients and to initiate early preventive measures. Previous studies had identified several risk factors for predicting CI-AKI after pPCI, such as pre-existing renal impairment, advanced age, high contrast medium volume use of intra-aortic balloon pump (IABP), peri-procedural hypotension, and hyperuricemia [16,19,[23][24][25][26], part of which were also identified as risk factors of CI-AKI in our study. Furthermore, we also found low FT3 was a novel risk factor of CI-AKI after pPCI.…”

Section: Discussionmentioning

confidence: 54%

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Negative association between free triiodothyronine level and contrast-induced acute kidney injury in patients undergoing primary percutaneous coronary intervention

et al. 2019

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Background: A low FT3 level is significantly associated with a variety of kidney disease and acute myocardial infarction (AMI). However, it remains unclear whether low FT3 is associated with CI-AKI in patients who underwent pPCI. Methods: Single-center retrospective study evaluated 363 STEMI patients undergoing pPCI. Patients were classfied into 2 groups, low FT3 group (FT3 < 3.1 pmol/L) and normal FT3 group (FT3 ≥ 3.1 pmol/L);CI-AKI was defined as an increase in the serum creatinine levels of ≥50% or 0.3 mg/dL above the baseline level within 48 h after contrast medium exposure. Results: Overall, 80(22.0%) patients had low FT3, and 59(16.3%) patients developed CI-AKI. The incidence of CI-AKI and in-hospital mortality was significantly higher in patients with low FT3 than normal (31.3% vs 12.0%; 15.0% vs 3.2%, respectively, both p < 0.0001). Multivariate logistic regression analysis indicated that low FT3 was an independent predictor of CI-AKI (odds ratio [OR] = 2.62, 95%CI:1.35-5.07, p < 0.05). In addition, low FT3 was associated with an increased risk of all-cause mortality during a mean follow-up period of 20 months (hazard ratio [HR] = 2.54, 95%CI:1.15-5. 60, p < 0.05). Conclusion: Low FT3 was associated with CI-AKI, short-and long-term mortality in STEMI patients after pPCI.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 54%

Negative association between free triiodothyronine level and contrast-induced acute kidney injury in patients undergoing primary percutaneous coronary intervention

et al. 2019

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“…Except for GDF-15, Our logistic regression model showed that anemia, primary PCI and eGFR <90ml/min/1.73m 2 are also independent risk factors for CIN, which is coinciding with previous study[ 31 – 33 ]. Roman reported that anemia and renal dysfunction were predictors of CIN in patients undergoing primary PCI[ 34 ].…”

Section: Discussionsupporting

confidence: 91%

Growth differentiation factor-15 levels and the risk of contrast induced nephropathy in patients with acute myocardial infarction undergoing percutaneous coronary intervention: A retrospective observation study

et al. 2018

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AimsTo investigate the association between growth differentiation factor-15 (GDF-15) and contrast-induced nephropathy (CIN) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI).MethodsA total of 311 patients with AMI were studied retrospectively. All patients were divided into two groups according to the occurrence of CIN after PCI. Baseline clinical data were compared between two groups. Multivariate logistic regression analysis was used to identify the risk factors for CIN. Cox regression analysis was used to identify the association between GDF-15, CIN and short-term outcome.ResultsThere were 80 patients in CIN group (average age was 71.60 ± 13.00 years; 67.5% male) and 231 patients in non-CIN group (average age was 63.80 ± 11.70 years; 71.9%male). The concentration of GDF-15 in CIN group was higher than that of non-CIN group (1232 ± 366.6 ng/L vs. 939.20 ± 309.6 ng/L, P <0.001). According to GDF-15 quartiles, patients were divided into four groups. Multivariate logistic model indicated that the highest quartile(Q4) was significantly associated with an increased risk of CIN compared with lower level of GDF-15 (Q1, Q2 and Q3) (OR : 3.572, 1.803–7.078, P < 0.001). Of 243 patients who could calculate the ACEF risk score, area under the curve (AUC) of GDF-15 was 0.793, 95%CI: 0.729–0.856, P < 0.001, while AUC of ACEF was 0.708, 95%CI: 0.630–0.786, P < 0.001. Using 10% and 30% as arbitrary thresholds to define patients at low, intermediate, and high risk, GDF-15 achieved a net reclassification improvement (NRI) of 0.32 (95%CI: 0.123–0.518, P = 0.001) compared with the ACEF risk score. Cox regression model showed that high concentration of GDF-15 (Q4) was significantly associated with an increased risk of all-cause mortality and major adverse clinical events (MACE) (HR: 8.434, 95%CI: 2.650–26.837, P <0.001; HR: 3.562, 95%CI: 1.658–7.652, P = 0.001) compared with low level of GDF-15 (Q1, Q2 and Q3). CIN was an independent predictor of all-cause mortality and MACE in AMI patients (HR: 3.535, 95%CI: 1.135–11.005, P = 0.029; HR: 5.154, 95%CI: 2.228–11.925, P <0.001).ConclusionGDF-15 levels increased in CIN group in AMI patients underwent PCI. GDF-15 was an independent risk factor for CIN in AMI patients underwent PCI. GDF-15 level and CIN are independent risk factors for all-cause mortality and MACE in short-term follow-ups.

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“…In addition, we excluded 11 post-procedure risk scores for CI-AKI according to our goals [18][19][20][21][22][23][24][25][26][27][28], and due to lack of C-reactive protein data, the Athens score was excluded [29]. We ultimately included 8 preoperative risk scores for CI-AKI in the final validation analysis [30][31][32][33][34][35][36][37].…”

Section: Overview Of Risk Scoresmentioning

confidence: 99%

Validation of pre-operative risk scores of contrast-induced acute kidney injury in a Chinese cohort

Zhang

Zhou

et al. 2020

BMC Nephrol

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Background: Pre-operative risk scores are more valuable than post-procedure risk scores because of lacking effective treatment for contrast-induced acute kidney injury (CI-AKI). A number of pre-operative risk scores have been developed, but due to lack of effective external validation, most of them are also difficult to apply accurately in clinical practice. It is necessary to review and validate the published pre-operative risk scores for CI-AKI. Materials and methods: We systematically searched PubMed and EMBASE databases for studies of CI-AKI preoperative risk scores and assessed their calibration and discriminatory in a cohort of 2669 patients undergoing coronary angiography or percutaneous coronary intervention (PCI) from September 2007 to July 2017. The definitions of CI-AKI may affect the validation results, so three definition were included in this study, CI-AKI broad1 was defined as an increase in serum creatinine (Scr) of 44.2 μmol/L or 25%; CI-AKI broad2, an increase in Scr of 44.2 μmol/L or 50%; and CI-AKI-narrow, an increase in Scr of 44.2 μmol/L. The calibration of the model was assessed with the Hosmer-Lemeshow test and the discriminatory capacity was identified by C-statistic. Results: Of the 8 pre-operative risk scores for CI-AKI identified, 7 were single-center study and only 1 was based on multi-center study. In addition, 7 of the scores were just validated internally and only Chen score was externally validated. In the validation cohort of 2669 patients, the incidence of CI-AKI ranged from 3.0%(Liu) to 16.4%(Chen) for these scores. Furthermore, the incidence of CI-AKI was 6.59% (178) for CI-AKI broad1, 1.44% (39) for CI-AKI broad2, and 0.67% (18) for CI-AKI-narrow. For CI-AKI broads, C-statistics varied from 0.44 to 0.57. For CI-AKI-narrow, the Maioli score had the best discrimination and calibration, what's more, the C-statistics of Maioli, Chen, Liu and Ghani was ≥0.7. Conclusion: Most pre-operative risk scores were established based on single-center studies and most of them lacked external validation. For CI-AKI broads, the prediction accuracy of all risk scores was low. The Maioli score had the best discrimination and calibration, when using the CI-AKI-narrow definition.

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A novel risk score model for prediction of contrast-induced nephropathy after emergent percutaneous coronary intervention

Cited by 39 publications

References 47 publications

Negative association between free triiodothyronine level and contrast-induced acute kidney injury in patients undergoing primary percutaneous coronary intervention

Negative association between free triiodothyronine level and contrast-induced acute kidney injury in patients undergoing primary percutaneous coronary intervention

Growth differentiation factor-15 levels and the risk of contrast induced nephropathy in patients with acute myocardial infarction undergoing percutaneous coronary intervention: A retrospective observation study

Validation of pre-operative risk scores of contrast-induced acute kidney injury in a Chinese cohort

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