Abstract
Background Contrast-induced nephropathy (CIN) becomes more and more frequent after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). There have been no reported meta-analyses to determine the role of these risk factors in predicting CIN in patients with STEMI undergoing PCI. So we made this meta-analysis to summarize the incidence of CIN in patients with STEMI undergoing PCI and to study associations between CIN and several risk factors that are mentioned in most prevention guidelines. Hypothesis The overall incidence of CIN in patients with STEMI undergoing PCI is not low. Many risk factors could influence the occurrence of CIN, such as hypertension, diabetes mellitus (DM), and lower estimated glomerular filtration rate. Methods Databases, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Chinese BioMedical (CBM), were searched for articles published before May 21, 2019, to identify all relevant studies on CIN. The pooled data were analyzed using either fixed-effects or random-effects models depending on heterogeneity (assessed via the I2 index). Results Twelve articles encompassing a total of 6342 patients were included. The overall pooled CIN incidence was 13.3% (95% CI: 10.4–17.1). The forest plots showed positive associations between CIN and the presence of hypertension, diabetes mellitus, history of prior myocardial infarction, age, damaged left anterior descending artery, Killip class ≥2, decreased left ventricular ejection fraction, lower estimated glomerular filtration rate, and left ventricular ejection fraction <40%; the odds ratios for these factors were 1.85 (95% CI: 1.57–2.18; p < 0.00001), 1.83 (95% CI: 1.47–2.29; p < 0.00001), 2.14 (95% CI: 1.46–3.14; p < 0.0001), 7.79 (95% CI: 5.24–10.34; p < 0.00001), 1.92 (95% CI: 1.15–3.22; p=0.01), 3.12 (95% CI: 2.21–4.40; p < 0.00001), −6.15 (95% CI: −9.52 to −2.79; p=0.0003), −15.06 (95% CI: −24.75 to −5.36; p=0.002), and 5.53 (95% CI: 1.10–27.95; p=0.04), respectively. Conclusion The overall incidence of CIN in patients with STEMI undergoing PCI was not low and was closely associated with hypertension, diabetes mellitus, history of prior myocardial infarction, age, damaged left anterior descending artery, Killip class ≥2, decreased left ventricular ejection fraction, lower estimated glomerular filtration rate, and left ventricular ejection fraction <40%.
Highlights
Percutaneous coronary intervention (PCI) has become increasingly important and common in the treatment of STsegment elevation myocardial infarction (STEMI), resulting in fewer ischemic complications, more survival myocytes, preserved ventricular function, and improved survival of patients when compared with treatment via pharmacologic reperfusion with brinolytic agents [1, 2]. e incidence rates of major adverse cardiovascular events (MACEs) are higher in patients with STEMI who undergo percutaneous coronary intervention (PCI) compared with patients with other types of coronary heart disease, such as non-ST-segment elevation acute coronary syndrome and stable angina [3]
contrast-induced nephropathy (CIN) may lead to worse clinical outcomes, including prolonged hospitalization, increased costs, repeat revascularization, and shortand long-term mortality. e mechanisms of CIN are vasoconstriction, oxidative stress, medullary ischemia, and direct toxic effects of contrast media (CM) [5, 6]. ere are no effective ways to prevent CIN some reports indicate that hydration to patients with STEMI can reduce CIN. erefore, it is important to recognize risk factors as early as possible while perioperation to prevent the incidence of CIN [7, 8]
Our study showed that the incidence of CIN in patients with ST-segment elevation myocardial infarction undergoing PCI was 13.3%
Summary
Contrast-induced nephropathy (CIN), a relatively infrequent complication after PCI in patients with STEMI, has attracted increasing attention [4]. What about the incidence of CIN and related risk factors in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI)? Erefore, the role of these risk factors in predicting CIN in patients with STEMI undergoing PCI remains controversial. Ere have been no reported metaanalyses to determine the role of these risk factors in predicting CIN in patients with STEMI undergoing PCI. Contrast-induced nephropathy (CIN) becomes more and more frequent after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Twelve articles encompassing a total of 6342 patients were included. e overall pooled CIN incidence was 13.3% (95% CI: 10.4–17.1)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
