Serum cystatin c and renal dysfunction in transradial versus transfemoral approaches in primary percutaneous coronary intervention

Abstract

Objectives: Contrast-induced nephropathy is one of the most common adverse side effects in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). Serum cystatin C level is a biomarker of the renal function test. We aimed to compare the degree of renal dysfunction in transradial primary PCI versus transfemoral primary PCI and to use of serum cystatin C as a predictor of contrast-induced nephropathy. Methods: This study included 90 patients who were admitted to the hospital with STEMI and who underwent a primary PCI and they were divided into Group I (45 patients): a primary PCI via femoral approach and Group II (45 patients): a primary PCI via radial approach. We estimated both serum cystatin C and serum creatinine after 72 h of primary PCI. Results: Serum cystatin C level post-PCI had high sensitivity results in correlation with CIN and non-CIN groups. Further, the significant effects were found in all patients in association with serum cystatin C before and after PCI. The cutoff value of serum cystatin C with receiver operating characteristic curve analysis before PCI was 1.1 mg/dL and after PCI was 1.3 mg/dL. Conclusion: The transradial approach for a primary PCI is an effective and safe approach alternative to the femoral approach. Serum cystatin C is a biomarker and a predictor of the occurrence of contrast-induced nephropathy in STEMI patients who underwent a primary PCI and is one of the most sensitive renal markers regarding CIN in comparison to serum creatinine level.