CHA2DS2-VAS-HSF Score as a Predictor for Contrast- Induced Nephropathy in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention
Abstract
Background: Contrast-Induced Nephropathy (CIN) is a serious problem that can be found in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). The development of CIN in hospitalized patients even with coronary revascularization can immediately increase morbidity and mortality both during treatment and long-term outcomes. In a recent study, a CHA2DS2-VASC-HSF score was reported to predict coronary artery severity and major cardiovascular events (MACE) as well as CIN in AMI patients without atrial fibrillation. The purpose of this study was to investigate the CHA2DS2-VASC score as a predictor of CIN in AMI patients undergoing PCI procedures.
Methods: This study was an ambispective cohort study of 53 AMI patients who were treated at cardiac care and underwent PCI procedures. The CHA2DS2-VASC-HSF score was calculated for each patient. From this study found 14 cases (26.4%) with a total CIN prevalence of 16.83%. CIN is defined as an increase in serum creatinine> 0.5 mg / dL or an increase in serum creatinine> 25% from baseline within 24 hours post PCI.
Results: Through the analysis of the ROC curve, we established the CHA2DS2- VASC-HSF score cut point> 5 as a predictor of CIN with a sensitivity of 78.57% and specificity of 66.6 %% (AUC 0.818, 95%: CI 3.018-6.142, p <0.001). By getting the equation from the linear regression assessment we also found the probability of the occurrence of CIN in accordance with the CHA2DS2-VASC-HSF score.
Conclusion: CHA2DS2-VASC score has a positive correlation with CIN. Therefore, this score can be used as a simple scoring system and can predict the incidence of CIN in AMI patients undergoing PCI procedures.
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References
Gleeson TG, Bulugahapitiya S. Contrast-induced nephropathy. Am J Roentgenol. 2004;183:1673– 89.
Cetin M, Cakici M, Zencir C, Tasolar H, Baysal E, Balli M, et al. Prediction of Coronary Artery Disease Severity Using CHADS2 and CHA2DS2-VASc Scores and a Newly Defined CHA2DS2-VASc-HS Score. Am J Cardiol. 2014;113:950-956.
Uysal OK, Turkoglu C, Duran M, Kaya MG, Sahin DY, Gur M, et al. Predictive value of newly defined CHA2DS2-VASC-HSF score for severity of coronary artery disease in STEMI. Kardio Pol. 2016;74:954-960.
Kurtul A, Yarlioglues M, Duran M. Predictive value of CHA2DS2-VASC score for contrast induced nephropathy after percutaneus coronary intervention for acute coronary syndrome. Am J Cardiol. 2017;119:819-825.
Modi R, Patted SV, Halkati PC, Porwal S, Ambar S, Prasad MR, et al. CHA2DS2-VASC-HSF score – new predictor of severity of coronary artery disease in 2976 patients. Int Jour Cardiology. 2016.10.093.
Thygesen K, Alpert JS, White HD; Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction. Universal definition of myocardial infarction. J Am Coll Cardiol 2007;50:2173e2195.
Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, Hindricks G, Kirchhof P; ESC Committee for Practice Guidelines (CPG). 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J. 2012;33:2719e2747.
McCullough PA. Contrast-induced acute kidney injury. J Am Coll Cardiol. 2008;51:1419-1428.
Gleeson TG, Bulugahapitiya S. Contrast-induced nephropathy. Am J Roentgenol. 2004;183:1673– 89.
Goldenberg I, Matetzky S. Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. CMAJ. 2005;172:1461–1471.
Golshahi J, Nasri H, Gharipour M. Contrast induced nephropathy; A literature review. Journal of Nephropathology. 2014;3(2):51-56.
Tepel M, Aspelin P, Lameire N. Contrast-Induced Nephropathy. A Clinical and Evidence-Based Approach. Circulation. 2006;113:1799-1806.
Kolonko A, Wiecek A, Kokot F. The nonselective adenosine antagonist theophylline does prevent renal dysfunction induced by radiographic contrast agents. J Nephrol. 1998;11:151-156.
Thomsen HS. Guidelines for contrast media from the European Society of Uro¬genital Radiology. AJR Am J Roentgenol. 2003;181:1463-71.
Bartholomew BA, Harjai KJ, Duk¬kipati S, et al. Impact of nephropathy af¬ter percutaneous coronary intervention and a method for risk stratification. Am J Cardiol. 2004;93:1515-9.
Murphy ME, Tublin ME, Li S. Influence of contrast media on the response of rat renal arteries to endothelin and nitric oxide: influence of contrast media. Invest Radiol. 1998;33:356-365
Mehran R, Nikolsky E. Contrast-induced nephropathy: Definition, epidemiology, and patients at risk. Kidney Int Suppl. 2006;100:11-15.
Heyman SN, Rosenberger C, Rosen S, Khamaisi M. Why is diabetes mellitus a risk factor for contrast induced nephropathy? Biomed Res Int. 2013;2013:123589.
Park HS, Kim CS, Hwang BH, Kim TH, Koh YS, Park HJ, et al. HDL Cholesterol Level Is Associated with Contrast Induced Acute Kidney Injury in Chronic Kidney Disease Patients Undergoing PCI. Scientific Reports. 2016.6:35774.
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