Abstract
BackgroundContrast-induced nephropathy (CIN) after primary percutaneous coronary intervention (PCI) is associated with increased mortality and morbidity. The aim of this study is to determine the frequency of CIN after primary PCI and its association with risk factors in patients with ST-segment elevation myocardial infarction (STEMI) at a tertiary care cardiac center in Pakistan.MethodologyIn this observational study, we included 282 patients who presented with STEMI and underwent primary PCI at the National Institute of Cardiovascular Disease, Karachi, Pakistan, from October 2017 to April 2018. The serum creatinine (mg/dL) levels were obtained at baseline and 48 to 72 hours after the primary PCI procedure, and patients with a 25% increase or ≥ 0.5 mg/dL rise in post-procedure creatinine level (after 48 to 72 hour) were categorized for CIN.ResultsOut of a total sample of 282 patients, 68.4% (193) were males, and the mean age was 56.4 ± 9.1 years. A majority of the patients, 78.7% (222), were hypertensive and 34% (96) were diabetic. The CIN was observed in 13.1% (37) of the patients, and increased risk of CIN was found to be associated with the presence of diabetes mellitus and increased (>200 mL) use of contrast during the procedure, with odds ratios of 2.3 (1.14-4.63) and 3.12 (1.36-7.17), respectively.ConclusionsThe CIN after PCI is a common complication associated with the presence of diabetes mellitus and the use of an increased amount of contrast during the procedure.
Highlights
Primary percutaneous coronary intervention (PCI) is the recommended and preferred reperfusion strategy for the patients with ST-segment elevation myocardial infarction (STEMI)
The aim of this study is to determine the frequency of Contrast-induced nephropathy (CIN) after primary PCI and its association with risk factors in patients with ST-segment elevation myocardial infarction (STEMI) at a tertiary care cardiac center in Pakistan
The CIN was observed in 13.1% (37) of the patients, and increased risk of CIN was found to be associated with the presence of diabetes mellitus and increased (>200 mL) use of contrast during the procedure, with odds ratios of 2.3 (1.14-4.63) and 3.12 (1.36-7.17), respectively
Summary
Primary percutaneous coronary intervention (PCI) is the recommended and preferred reperfusion strategy for the patients with ST-segment elevation myocardial infarction (STEMI). A decrease in glomerular filtration rate after procedure due to injection of contrast media, known as contrast-induced nephropathy (CIN), remains a real risk and is associated with increased risk of mortality and morbidity, leading to prolongation of hospital stay, increased utilization of resources, and increased healthcare cost [2,3]. CIN is reported to be associated with increased in-hospital mortality rate after primary PCI, with around four to eightfold increased risk of in-hospital mortality [2,9]. Contrast-induced nephropathy (CIN) after primary percutaneous coronary intervention (PCI) is associated with increased mortality and morbidity. The aim of this study is to determine the frequency of CIN after primary PCI and its association with risk factors in patients with ST-segment elevation myocardial infarction (STEMI) at a tertiary care cardiac center in Pakistan
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