The effect of whole blood viscosity on contrast-induced nephropathy development in patients undergoing percutaneous coronary intervention

Abstract

ABSTRACT Objective In our study, we aimed to investigate how whole blood viscosity (WBV) affects the development of contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary intervention (PCI). Methods In our study, 500 patients who applied to the cardiology clinic and underwent PCI for elective procedure, ST segment elevation myocardial infarction (STEMI), and non-STEMI were prospectively included. Before the procedure, we calculated WBV using the formula [(0.12× hematocrit) + (0.17×(total protein – 2.07)]. We defined CIN as the absolute (≥0.5 mg/dl) or relative increase (≥25%) in serum creatinine 48–72 h after exposure to a contrast agent compared with baseline serum creatinine values. Results CIN was developed in 69 (13.6%) of the 500 patients in the study. PCI was performed in 206 patients (41.2%) electively, 175 (35%) due to non-STEMI, and 119 (23%) due to STEMI. CIN was observed in 20.2% of the STEMI group, 13.7% of the non-STEMI group, and 10.2% of the elective PCI group. Multivariate logistic regression analysis results show that the independent predictors of CIN are low ejection fraction [OR:0.95 (95% CI:0.92–0.97); p < 0.001], low glomerular filtration rate [OR:0.96 (95% CI:0.95–0.98); p < 0.001], and increased amount of contrast agent [OR:1.008 (95% CI:1.004–1.01); p < 0.001]. When all patients were examined, no significant relationship was found between WBV and CIN. However, in the subgroup evaluation, it was concluded that low WBV was an independent predictor in elective PCI patients [OR:0.60 (95% CI:0.36–0.99); p = 0.04] for CIN. Conclusion We found that low WBV was an independent predictor of CIN in patients undergoing elective PCI(NCT04703049).