Is coronary artery disease complexity valuable in the prediction of contrast induced nephropathy besides Mehran risk score, in patients with ST elevation myocardial infarction treated with primary percutaneous coronary intervention?

Abstract

Background: The association of coronary artery disease complexity with contrast induced nephropathy (CIN) in patients with acute ST segment elevation myocardial infarction (STEMI) is inadequately evaluated and to our knowledge the association between SYNTAX score (SS) and Mehran score (MS) have not been studied. The aim of the present study is to clarify the incidence of CIN and to identify demographic, clinical and procedural variables associated with CIN in patients who underwent primary percutaneous coronary intervention (PPCI) due to acute STEMI, besides the association between MS and SS with CIN.

Methods: We analysed the clinical data of 402 patients (309 male, 93 female, mean age 63.8 ± 12.65 year) with 179 (44.5%) anterior MI, 104 (25.9%) inferior MI, 119 (29.6%) inferior MI with right ventricular involvement who underwent PPCI.

Results: We found that CIN was observed in 32.6% of patients. The SS (OR=1.037, %95CI=1.012-1.062, p=0.003), MS (OR=1.072, %95CI=1.025-1.121, p=0.003), HDL (OR=0.974, %95CI=0.949-0.999, p=0.044) were the independent predictors of CIN. The cut off value to show CIN for SS was 31.5 (sensitivity=79.4%, specificity=88.6%) and MS was 12.5 (sensitivity=73.3%, specificity=88.9%) in ROC curve analysis.

Conclusion: In conclusion, besides MS, SS may be a valuable marker to identify patients at high risk for CIN in patients undergoing primary percutaneous intervention.

Keywords: Contrast; Coronary; Mehran score; Myocardial infarction; Nephropathy; SYNTAX score.