The Role of Serum Cystatin C in the Early Detection of Contrast-Induced Nephropathy after Coronary Intervention

Abstract

Objective: Contrast induced nephropathy is the most common complication for both coronary angiography and percutaneous coronary intervention. The aim of the present study is to investigate the role of serum cystatin C among patients undergoing coronary angiography for earlier detection of contrast induced nephropathy. Materials and Methods:The study included 80 elective patients attending the cardiology center (48 males, 32 females). The study was conducted in cardiac catheterization unit at Al-Hussein Medical City/ Kerbala Health Directorate-Holy Kerbala, Iraq. Clinical examination and laboratory investigations were made before and 24 hours after angiography. These investigations include: serum creatinine, blood urea, estimated GFR and serum cystatin C.Results: According to the definition, contrast induced nephropathy occurred in 19 patients 23.8% with grade 0 to 2 of renal dysfunction. There were significant increments in serum creatinine, cystatin C and eGFR after 24 hours of angiography/angioplasty procedures p<0.001, 0.01 respectively. Receiver-operating characteristic analysis showed a higher area under the curve for creatinine 0.805 (95% CI=0.688, 0.921) p=0.001, 78.9% sensitivity and 60.7% specificity than serum cystatin C 0.777 (95% CI=0.673-0.881) P=0.001 sensitivity=78.9% and specificity=64%, a cutoff level of cystatin C>7 ng/ml. Conclusion:Cystatin C was a good biomarker for earlier diagnosis of contrast induced nephropathy when compared with blood urea and eGFR.