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.

Highlights

  • Contrast-Induced Nephropathy (CIN) is a serious problem that can be found in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI)

  • Hasil: Melalui analisis kurva receiving operator characteristic (ROC), didapati nilai titik potong skor CHA2DS2-VASC-HSF > 5sebagai prediktor CIN dengan sensitivitas sebesar 78.57% dan spesifisitas sebesar 66.6%% (AUC 0.818, 95%:CI 3.018-6.142, p

  • Pada analisis kurva ROC, nilai area under the curve untuk prediksi CIN adalah 0.818 p=0.001 untuk nilai skor CHA2DS2VASC-HSF>5 (Gambar 1; Tabel 2)

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Summary

Indonesian Journal of Cardiology

CHA2DS2-VAS-HSF Score as a Predictor for ContrastInduced Nephropathy in Acute Coronary Syndrome. Herman William Parlindungan, Refli Hasan, Cut Aryfa Andra, Nizam Zikri Akbar, Ali Nafiah Nasution, Harris Hasan, Zainal Safri, Anggia C. Departemen Kardiologi dan Kedokteran Vaskular, Universitas Sumatera Utara, RSUP H. Correspondence: dr Herman William Parlindungan Departemen Kardiologi dan Kedokteran Vaskular, Universitas Sumatera Utara, RSUP H. Adam Malik, Medan, Indonesia E-mail: williams_herman19@yahoo. com

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