Predictors of Contrast-Induced Nephropathy in Acute Coronary Syndrome Patients with Renal Dysfunction.
- Author:
Soo Hwan PARK
1
;
Myung Ho JEONG
;
Jung Ae RHEE
;
Jin Su CHOI
;
Seung Hwan HWANG
;
Jum Suk KO
;
Min Goo LEE
;
Doo Sun SIM
;
Keun Ho PARK
;
Nam Sik YOON
;
Hyun Ju YOON
;
Kye Hun KIM
;
Young Joon HONG
;
Ju Han KIM
;
Youngkeun AHN
;
Jeong Gwan CHO
;
Jong Chun PARK
;
Jung Chaee KANG
Author Information
1. The Heart Center of Chonnam National University Hospital, Gwangju, Korea. myungho@chollian.net
- Publication Type:Original Article
- Keywords:
Contrast-induced nephropathy;
Acute coronary syndrome;
Renal dysfunction
- MeSH:
Acute Coronary Syndrome;
Body Mass Index;
Coronary Angiography;
Creatinine;
Hemoglobins;
Humans;
Incidence;
Logistic Models;
Percutaneous Coronary Intervention;
Stroke Volume
- From:Korean Journal of Medicine
2012;82(2):185-193
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Contrast-induced nephropathy (CIN) is an important complication of diagnostic coronary angiography (CAG) and percutaneous coronary intervention (PCI). We investigated the incidence and predictors of the development of CIN in acute coronary syndrome (ACS) patients with renal dysfunction undergoing PCI. METHODS: From January 2005 to June 2010, we evaluated the clinical, laboratory, and angiographic data of 406 patients with ACS who had a serum creatinine > or = 1.3 mg/dL and underwent CAG or PCI. The patients were divided into two groups according to the development of CIN (CIN, n = 92; no CIN, n = 314). RESULTS: Of the 406 patients, 92 (22.7%) developed CIN. The development of CIN was associated with a lower baseline body mass index (p = 0.001), decreased left ventricular ejection fraction (LVEF) (p < 0.001), decreased creatinine clearance (CrCl) (p < 0.001), lower albumin (p < 0.001), lower hemoglobin (p = 0.003), higher N-terminal pro B type natriuretic peptide (p = 0.001), and greater contrast medium volume (CMV) (p = 0.021). On multiple logistic regression analysis, LVEF < 40% (OR, 4.080; 95% CI, 2.087-7.977; p < 0.001), albumin < 3.5 g/dL (OR, 2.042; 95% CI, 1.211-3.440; p = 0.007), and CMV/CrCl > or = 3.5 (OR, 1.964; 95% CI, 1.243-3.101; p = 0.004) were independent predictors of CIN. The cut-off value for CMV/CrCl was 3.5, and that for albumin was 3.55 g/dL. CONCLUSIONS: CIN occurred in 22.7% of the patients with ACS and renal dysfunction who underwent CAG or PCI. Independent predictors of CIN were decreased LVEF, decreased albumin, and increased CMV/CrCl ratio.
