NT-proBNP as a Predictive Biomarker for Contrast-Induced Nephropathy in ACS Patients Undergoing Coronary Angiogram – An Observational Study

Abstract

Objectives: 1. To assess the value of baseline NTproBNP at admission and to determine the levels of serum creatinine at 48 hours and 72 hours after procedure for evidence of contrast-induced nephropathy (CIN) for patients undergoing CAG. 2. To evaluate the relationship between the values of NTproBNP and evidence of CIN. Materials and Methods: This is an observational study performed between June 2021-November 2021 at Nizams Institute of Medical Sciences in 75 patients diagnosed with ACS. we assessed the role of nt pro bnp as a predictive biomarker for diagnosis of contrast induced nephropathy in patients of ACS undergoing coronary angiography. Serum creatinine is repeated at 48 h post procedure and compared to baseline. Results: Spearman’s correlation test was used to assess the correlation between NT-proBNP values and ejection fraction on the 2D echo. The rho value (-0.69) was suggestive of a strong negative correlation. P value & lt; 0.001 making it statistically significant. Simple linear regression analysis was used to predict the NT-proBNP levels by ejection fraction percentage among study patients, it showed that, for every 1% decrease in ejection fraction, the NT-proBNP levels will significantly increase by 102.90 pg/mL at P and lt; 0.001. Wilcoxon Signed Rank test was used to compare the baseline serum creatinine values with 48/72 h serum creatinine values after undergoing angiography with contrast, incidence of acute kidney injury (AKI) as shown by the resulting P value was and lt; 0.001, thus statistically significant. The ROC curve analysis to establish the association between NT-proBNP as a marker for incidence of AKI (CIN) shows shows that, NT-proBNP cut off and gt;1670 pg/mL has a sensitivity of 81.82% and specifity of 98.44% and is statistically significant with P value and lt; 0.001. Conclusion: It was observed that NT-proBNP >1670 pg/mL prior to the procedure, was significantly associated with the risk of development of contrast induced nephropathy. Measurement of serum NT-proBNP pre procedure aids in identifying at risk population for developing CIN.