TY - JOUR
T1 - Contrast Volume to Glomerular Filtration Ratio and Acute Kidney Injury among ST-Segment Elevation Myocardial Infarction Patients Treated with Primary Percutaneous Coronary Intervention
AU - Zahler, David
AU - Rozenfeld, Keren Lee
AU - Merdler, Ilan
AU - Peri, Yogev
AU - Shacham, Yacov
N1 - Publisher Copyright:
© 2019 S. Karger AG, Basel. All rights reserved.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Introduction: The ratio of contrast media volume to glomerular filtration rate (contrast/GFR) has been shown to correlate with the occurrence of contrast-induced acute kidney injury (CI-AKI) in unselected patient populations who underwent percutaneous coronary intervention (PCI). Objective: We evaluated the possible utilization of this marker and optimal cutoff among ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI. Methods: We retrospectively included 419 patients with STEMI treated with primary PCI. The occurrence of CI-AKI was defined by the KDIGO criteria as an increase in serum creatinine of ≥0.3 mg/dL within 48 h following PCI. A receiver-operator characteristic (ROC) curve was used to identify the optimal cutoff value of contrast/GFR ratio to predict CI-AKI. This value was then assessed using multivariable logistic regression. Results: The overall incidence of CI-AKI was 9%. The contrast/GFR ratio was significantly higher among patients with CI-AKI (2.7 ± 1.2 vs. 1.9 ± 0.9; p < 0.001). According to the ROC curve analysis, the optimal cutoff value of contrast/GFR ratio to predict AKI was measured as ≥2.13, with 70% sensitivity and 60% specificity (AUC 0.65, 95% CI 0.56-0.74; p = 0.002). In a multivariate logistic regression model, contrast/GFR ratio ≥2.13 was independently associated with CI-AKI (OR 2.46, 95% CI 1.09-5.57; p = 0.03). Conclusions: Among STEMI patients undergoing primary PCI, contrast/GFR ratio ≥2.13 was independently associated with CI-AKI.
AB - Introduction: The ratio of contrast media volume to glomerular filtration rate (contrast/GFR) has been shown to correlate with the occurrence of contrast-induced acute kidney injury (CI-AKI) in unselected patient populations who underwent percutaneous coronary intervention (PCI). Objective: We evaluated the possible utilization of this marker and optimal cutoff among ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI. Methods: We retrospectively included 419 patients with STEMI treated with primary PCI. The occurrence of CI-AKI was defined by the KDIGO criteria as an increase in serum creatinine of ≥0.3 mg/dL within 48 h following PCI. A receiver-operator characteristic (ROC) curve was used to identify the optimal cutoff value of contrast/GFR ratio to predict CI-AKI. This value was then assessed using multivariable logistic regression. Results: The overall incidence of CI-AKI was 9%. The contrast/GFR ratio was significantly higher among patients with CI-AKI (2.7 ± 1.2 vs. 1.9 ± 0.9; p < 0.001). According to the ROC curve analysis, the optimal cutoff value of contrast/GFR ratio to predict AKI was measured as ≥2.13, with 70% sensitivity and 60% specificity (AUC 0.65, 95% CI 0.56-0.74; p = 0.002). In a multivariate logistic regression model, contrast/GFR ratio ≥2.13 was independently associated with CI-AKI (OR 2.46, 95% CI 1.09-5.57; p = 0.03). Conclusions: Among STEMI patients undergoing primary PCI, contrast/GFR ratio ≥2.13 was independently associated with CI-AKI.
KW - Acute renal injury
KW - Contrast volume
KW - Glomerular filtration rate
KW - ST-segment elevation myocardial infarction
UR - http://www.scopus.com/inward/record.url?scp=85076323633&partnerID=8YFLogxK
U2 - 10.1159/000504534
DO - 10.1159/000504534
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C2 - 31801134
AN - SCOPUS:85076323633
SN - 1664-3828
VL - 10
SP - 108
EP - 115
JO - CardioRenal Medicine
JF - CardioRenal Medicine
IS - 2
ER -