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Incidence, Predictors and Outcomes of Contrast Induced Nephropathy in Patients with ST Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention Cover

Incidence, Predictors and Outcomes of Contrast Induced Nephropathy in Patients with ST Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Global Heart
Volume 16 (2021): Issue 1
By: Mohamed Khalfallah,  Amany Allaithy and  Dina A. Maria  
Open Access
|Aug 2021
Figures & tables

Figures & Tables

Table 1

Demographic, clinical characteristics, angiographic results and outcomes of the two groups.

Group I (No CIN)
(N = 496) (89.4%)		Group II (CIN)
(N = 59) (10.6%)		P value
Age, years57.44 ± 10.961.42 ± 9.810.008*
Male gender, n (%)296 (59.7%)30 (50.8%)0.193  
Hypertension, n (%)172 (34.7%)21 (35.6%)0.889  
Diabetes mellitus, n (%)165 (33.3%)34 (57.6%)0.001*
Smoking, n (%)134 (27.0%)20 (33.9%)0.264  
Dyslipidemia, n (%)173 (34.9%)18 (30.5%)0.504  
Prior MI, n (%)43 (8.7%)9 (15.3%)0.101  
PVD, n (%)93 (18.8%)15 (25.4%)0.221  
CKD, n (%)61 (12.3%)13 (22.0%)0.038*
Height (cm)167.3 ± 4.76166.4 ± 5.080.181  
Weight (kg)70.85 ± 7.1370.63 ± 10.00.831  
BMI (kg/m2)24.54 ± 2.9525.00 ± 3.570.269  
Heart rate (bpm)66.81 ± 10.366.54 ± 10.50.851  
Atrial fibrillation, n (%)43 (8.7%)10 (16.9%)0.041*
Systolic BP, mmHg123.6 ± 18.2122.2 ± 30.20.590  
Diastolic BP, mmHg81.91 ± 9.0280.76 ± 18.90.427  
LVEF, (%)45.50 ± 4.7244.31 ± 5.690.076  
Beta blockers, n (%)303 (61.1%)33 (55.9%)0.444  
Antiplatelet, n (%)350 (70.6%)39 (66.1%)0.479  
NSAIDs use, n (%)103 (20.8%)24 (40.7%)0.001*
ACEI/ARB, n (%)260 (52.4%)34 (57.6%)0.449  
Statins, n (%)362 (73.0%)39 (66.1%)0.264  
Volume of contrast agent, (ml)182.2 ± 68.9213.2 ± 83.50.002*
LM coronary artery, n (%)7 (1.4%)1 (1.7%)0.863  
LAD coronary artery, n (%)210 (42.3%)21 (35.6%)0.320  
CX coronary artery, n (%)142 (28.6%)16 (27.1%)0.808  
RCA coronary artery, n (%)137 (27.6%)21 (35.6%)0.200  
Mortality, n (%)22 (4.4%)7 (11.9%)0.015*
No-reflow phenomenon, n (%)40 (8.1%)7 (11.9%)0.322  
Heart failure, n (%)36 (7.3%)11 (18.6%)0.003*
Major bleeding, n (%)16 (3.2%)1 (1.7%)0.519  
Cardiac arrest, n (%)14 (2.8%)5 (8.5%)0.024*
Re-infarction, n (%)13 (2.6%)1 (1.7%)0.668  
Cardiogenic shock, n (%)34 (6.9%)10 (16.9%)0.007*

[i] PVD: peripheral vascular diseases; CKD: chronic kidney diseases; BMI: body mass index; BP: blood pressure; LVEF: left ventricular ejection fraction; NSAIDs: non-steroidal anti-inflammatory drugs; ACEI/ARB: angiotensin converting enzyme inhibitors/angiotensin receptor blockers; LM: left main; CX: circumflex; LAD: left anterior descending; *: significant P value.

Figure 1

Outcomes of primary percutaneous coronary intervention of both groups.

Table 2

Laboratory results of the two groups.

Group I (No CIN)
(N = 496) (89.4%)		Group II (CIN)
(N = 59) (10.6%)		P value
Hemoglobin level, g/dL11.46 ± 1.5411.10 ± 1.690.093  
Random blood sugar, mg/dl167.3 ± 71.1193.9 ± 83.90.008*
Creatinine pre-procedure, mg/dl1.062 ± 0.221.154 ± 0.390.002*
Creatinine post-procedure, mg/dl1.109 ± 0.252.175 ± 0.880.001*
CK-MB, U/L76.60 ± 37.880.20 ± 34.90.487  
E-GFR pre-procedure, n (%)
≥60 (mL/min/1.73 m2)377 (76.0%)32 (54.2%)0.001*
30–59 (mL/min/1.73 m2)111 (22.4%)23 (39.0%)
<30 (mL/min/1.73 m2)8 (1.6%)4 (6.8%)
E-GFR post-procedure, n (%)
≥60 (mL/min/1.73 m2)347 (70.0%)12 (20.3%)0.001*
30–59 (mL/min/1.73 m2)129 (26.0%)33 (55.9%)
<30 (mL/min/1.73 m2)20 (4.0 %)14 (23.7%)
E-GFR pre-procedure, (M ± SD)
≥60 (mL/min/1.73 m2)84.98 ± 6.9283.06 ± 10.70.001*
30–59 (mL/min/1.73 m2)49.58 ± 8.0946.46 ± 7.28
<30 (mL/min/1.73 m2)24.50 ± 0.5728.50 ± 0.70
E-GFR post-procedure, (M ± SD)
≥60 (mL/min/1.73 m2)80.48 ± 9.8567.83 ± 3.710.001*
30–59 (mL/min/1.73 m2)46.67 ± 8.3936.94 ± 9.83
<30 (mL/min/1.73 m2)22.90 ± 3.0719.50 ± 6.63

[i] CK-MB: Creatine kinase myocardial band; E-GFR: estimated glomerular filtration rate; *: significant P value.

Figure 2

E-GFR pre and post primary percutaneous coronary intervention of both groups.

Table 3

Multivariate regression analysis showing the independent predictors of contrast induced nephropathy.

Multivariate analysisP value
OR(95% CI)
Age > 60 years6.0833.143–11.770.001*
Diabetes mellitus2.4911.327–4.6750.005*
Atrial fibrillation1.0870.259–4.5610.910  
Chronic kidney diseases1.9340.527–7.1000.320  
NSAIDs use2.7081.393–5.2630.003*
Volume of contrast agent > 200 ml6.5433.382–12.650.001*
Cardiogenic shock4.5141.738–11.720.002*
Heart failure2.2160.920–5.3410.076  
Cardiac arrest2.6880.716–10.090.143  

[i] OR: Odds ratio; CI: confidence interval; NSAIDs: non-steroidal anti-inflammatory drugs; *: significant P value.

DOI: https://doi.org/10.5334/gh.1071 | Journal eISSN: 2211-8179
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Language: English
Submitted on: May 31, 2021
Accepted on: Jul 23, 2021
Published on: Aug 31, 2021
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
Contrast induced nephropathy,
ST elevation myocardial infarction,
primary percutaneous coronary intervention

© 2021 Mohamed Khalfallah, Amany Allaithy, Dina A. Maria, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

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