Abstract
Background The thrombolysis in myocardial infarction risk index (TRI) was developed to estimate prognosis at the initial contact of the healthcare provider in coronary artery disease patients without laboratory parameters. In this study, we aimed to investigate the relationship of the baseline TRI and contrast-induced nephropathy (CIN) in patients with ST-elevation myocardial infarction (STEMI). Methods A total of 963 consecutive STEMI diagnosed patients who underwent primary percutaneous intervention were included in the study. TRI was calculated using the formula “heart rate × (age/10) 2/SBP” on admission. CIN was defined as an increase in serum creatinine concentration ≥25%, 48 hours later over the baseline. Results Of the total of 963 patients, CIN was observed in 13% (n=128). TRI was significantly higher in the CIN (+) group compared with the CIN (−) group (32.9 ± 18.8 vs 19.9 ± 9.9, P < 0.001). There was a stronger correlation between CIN and age, diastolic blood pressure, heart rate, Killip class, left ventricular ejection fraction, amount of contrast media, and diabetes mellitus. The amount of contrast media (OR 1.010, 95% CI 1.007–1.012, P < 0.001) and TRI (OR 1.047, 95% CI 1.020–1.075, P=001) were independent predictors of CIN. The best threshold TRI for predicting CIN was ≥25.8, with a 67.1% sensitivity and 80.4% specificity (area under the curve (AUC): 0.740, 95% CI: 0.711–0.768, P < 0.001). Conclusion TRI is an independent predictor of CIN, and it may be used as a simple and reliable risk assessment of CIN in STEMI patients without the need for laboratory parameters.
Highlights
Contrast nephropathy (CIN) is characterized by an acute disruption in renal functions following exposure to contrast agents, and different studies have reported its incidence as 5–25% [1, 2]
E thrombolysis in myocardial infarction risk index (TRI) is a simple risk score designed for using at initial presentation to predict mortality in ST-elevation myocardial infarction (STEMI) patients; it does not include any laboratory variables. e TRI is derived from three readily available clinical variables and is calculated using the equation (heart rate × 2/systolic blood pressure) [7, 8]
We aimed to evaluate the effectiveness of TRI, which is a clinical score easy to calculate in STEMI patients undergoing primary percutaneous intervention
Summary
Contrast nephropathy (CIN) is characterized by an acute disruption in renal functions following exposure to contrast agents, and different studies have reported its incidence as 5–25% [1, 2]. Many factors are associated with the development of CIN, including advanced age, increased amount of contrast agent, basal renal failure, diabetes mellitus (DM), and hypertension (HT) [3]. It may develop more commonly after primary percutaneous intervention. E thrombolysis in myocardial infarction risk index (TRI) is a simple risk score designed for using at initial presentation to predict mortality in STEMI patients; it does not include any laboratory variables. TRI has been linked to mortality and morbidity in many cardiovascular diseases such as ST-elevation myocardial infarction (STEMI), pulmonary embolism, and acute heart failure [9]
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