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. 2025 May 26;14(11):3725.
doi: 10.3390/jcm14113725.

Contrast-Induced Nephropathy (CIN) After Invasive Treatment of Acute Coronary Syndromes-Predictors, Short and Long-Term Outcome

Janusz Sielski  1 , Karol Kaziród-Wolski  1 , Aleksandra M Piotrowska  1 , Bartłomiej Jurczak  1 , Anna Klasa  1 , Kacper Kozieł  1 , Maciej Ludew  1 , Filip Maj  1 , Lena Merchel  1 , Kamil Pytlak  1 , Michał Zabojszcz  1 , Zbigniew Siudak  1
Affiliations

Contrast-Induced Nephropathy (CIN) After Invasive Treatment of Acute Coronary Syndromes-Predictors, Short and Long-Term Outcome

Janusz Sielski et al. J Clin Med. .

Abstract

Background/Objectives: Contrast-induced nephropathy (CIN) is a well-documented complication following coronary angiography and percutaneous coronary intervention (PCI). This study aims to evaluate the predictors of CIN and its effect on outcomes in patients with acute coronary syndrome (ACS). Methods: A retrospective study included 1579 patients who underwent coronary angiography or PCI. Results: The overall incidence of in-hospital CIN was 6.8%, with the highest incidence in the group with eGFR <30 mL/min/1.73 m2 at 21.6%. Non-radial vascular access was an independent predictor of CIN occurrence (OR = 2.06 [1.37-3.08]; p < 0.001). The risk of death within 30 days was influenced by history of stroke (OR = 4.94 [1.58-15.51]; p = 0.006), glucose level on admission (per 10-unit increase) (OR = 1.07 [1.04-1.1]; p < 0.001), occurrence of CIN (OR = 5.64 [2.49-12.79]; p < 0.001), and hemoglobin level (OR = 0.77 [0.65-0.92]; p = 0.003). The risk of death within 365 days was increased by age (OR = 1.05 [1.02-1.07]; p < 0.001), history of stroke (OR = 2.45 [1.02-5.89]; p = 0.046), glucose levels on admission (per 10-unit increase) (OR = 1.05 [1.03-1.08]; p < 0.001), occurrence of CIN (OR = 2.62 [1.42-4.84]; p = 0.002), and hemoglobin concentration (OR = 0.78 [0.7-0.88]; p = 0.003). An independent predictor of hospitalization for acute or exacerbation of chronic renal failure was baseline creatinine concentration (OR = 3.44 [2.4-4.93]; p < 0.001). Conclusions: The incidence of CIN is significant, particularly in patients with severe pre-existing renal impairment. Non-radial vascular access is an independent predictor of CIN. The occurrence of CIN is a strong independent predictor of both short-term and long-term mortality.

Keywords: acute coronary syndromes; contrast-induced nephropathy; kidney disease; long-term outcome; vascular access.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Population of the study. CIN, contrast-induced nephropathy; eGFR, estimated glomerular filtration rate.
Figure 2
Figure 2
Survival probability according to eGFR group. eGFR, estimated glomerular filtration rate.
Figure 3
Figure 3
Hospitalization due to acute or chronic renal failure probability according to the eGFR group. eGFR, estimated glomerular filtration rate.
Figure 4
Figure 4
Contrast-Induced Nephropathy (CIN) After Invasive Treatment of Acute Coronary Syndromes—Predictors, Short and Long-Term Outcome.
See this image and copyright information in PMC

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