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. 2024 Feb 10;10(4):e25926.
doi: 10.1016/j.heliyon.2024.e25926. eCollection 2024 Feb 29.

Prevalence of contrast-induced nephropathy after primary percutaneous coronary intervention at a tertiary referral hospital

Zahra Masoomi  1 , Ali Mohammad Nasirian  2 , Mansoor Namazi  2 , Moein Zangiabadian  3 , Abdoreza Dayani  2 , Mohammad Shahidi  1 , Hossein Saghafi  4 , Amir Ghaffari Jolfayi  2
Affiliations

Prevalence of contrast-induced nephropathy after primary percutaneous coronary intervention at a tertiary referral hospital

Zahra Masoomi et al. Heliyon. .

Abstract

Objective: This study aimed to quantify the incidence of Contrast-induced nephropathy (CIN) in patients undergoing primary percutaneous coronary intervention (PPCI) due to acute ST-elevation myocardial infarction (STEMI).

Methods: From April 2019 to March 2022, a prospective, observational study enrolled 213 consecutive STEMI patients referred to a tertiary hospital for PPCI. Participants were divided into tow groups based on the presence or absence of contrast-induced nephropathy. The chi-square test (χ2) and Student's t-test evaluated the data, with logistic regression identifying CIN's independent predictors.

Results: Results: In this study, the incidence of contrast-induced nephropathy was observed at 13.1% (N = 28). Several factors were more prevalent among patients exhibiting contrast-induced nephropathy. These factors encompassed: radial access for coronary angiography over the femoral method (P = 0.021), elevated contrast volume (P = 0.003), smoking (P = 0.009), diabetes (P = 0.04), heart failure (P = 0.049), a history of coronary artery bypass graft (P = 0.006), diminished left ventricular ejection fraction indicating systolic dysfunction (P = 0.012), cardiogenic shock (P = 0.046), increased BUN at the time of admission (P = 0.043), decreased initial GFR (P = 0.004), and prior consumption of medications such as aspirin (P = 0.002), diuretics (P = 0.046), beta blockers (P = 0.04), angiotensin-converting enzyme inhibitors (P = 0.033), angiotensin receptor blockers (P = 0.02). Other relevant conditions included anemia (P = 0.012), leukocytosis (P = 0.011), hypercholesterolemia (P = 0.034), and reduced HDL levels (P = 0.004).Through logistic regression, key predictors for the onset of contrast-induced nephropathy were determined, which included heart failure (OR: 5.52; 95% CI: 1.08-28.24), radial access (OR: 12.71; 95% CI: 1.45-110.9), hypercholesterolemia (OR: 1.02; 95% CI: 1.004-1.04), increased BUN upon admission (OR: 1.11; 95% CI: 1.006-1.24), and leukocytosis (OR: 2.03; 95% CI: 1.18-3.49).

Conclusions: While heart failure, radial access, hypercholesterolemia, elevated BUN at admission, and leukocytosis significantly influenced renal filtration deterioration post-PPCI, it's evident that CIN is multifactorial. Further studies are crucial to elucidate the underlying factors.

Keywords: Contrast-induced nephropathy; Myocardial infarction; Primary percutaneous coronary intervention.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Timeline of Serum Creatinine (mg/dL) in the hospitalization days.
Fig. 2
Fig. 2
Labtests changes in CIN proup compared to Non-CIN (%).
See this image and copyright information in PMC

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