Predictors of contrast nephropathy after percutaneous intervention of chronic total occlusion in patients with chronic coronary syndrome: A single-center study

Abstract

Objectives: This study was planned to determine the predictors of contrast nephropathy developing after percutaneous coronary intervention (PCI) in patients who underwent coronary angiography due to chronic coronary syndrome and were found to have chronic total occlusion (CTO). Patients and methods: The retrospective observational study included 110 patients with chronic coronary syndrome who were diagnosed with CTO between March 2017 and February 2023. All patients were divided into two groups: 53 patients (29 males, 14 females; mean age: 62.8±10.2 years; range, 42 to 84 years) who developed contrast-induced nephropathy (Group 1) and 57 patients (38 males, 19 females; mean age: 58.8±11.2 years; range, 37 to 79 years) who did not (Group 2). Results: The mean age of the patients in Group 1 was statistically greater than in Group 2 (p=0.04). In the multivariate regression analysis we performed for the prediction of contrast nephropathy in patients with CTO, chronic renal failure (OR: 0.025; 95% CI: 0.001-0.430, p=0.01), amount of opaque substance (OR: 1.115; 95% CI: 1.031-1.206, p=0.006), left ventricular ejection fraction (OR: 0.683; 95% CI: 0.551-0.847, p=0.001), and glucose (OR: 1.046; 95% CI: 1.014-1.078, p=0.004) were found to be independent predictors of contrast nephropathy. Conclusion: Our study revealed that baseline high creatinine (underlying chronic renal failure), high blood sugar that increases plasma osmolarity (uncontrolled diabetes mellitus), high amount of opaque material used, and low left ventricular ejection fraction are predictors of post-PCI contrast nephropathy. Paying attention to correctable risk factors before giving opaque material to patients for whom PCI is planned is valuable in terms of reducing kidney damage.