A novel risk assessment model of contrast-induced nephropathy after percutaneous coronary intervention in patients with diabetes.
The purpose of our study was to develop a simple clinical pre-procedure risk model based on clinical characteristics for the prediction of contrast-induced nephropathy (CIN) and major adverse cardiac events (MACEs) after percutaneous coronary intervention (PCI) in patients with diabetes. A total of 1113 patients with diabetes who underwent PCI with contrast exposure were randomized into a development group (n = 742) and a validation group (n = 371) in a 2:1 ratio. CIN was defined as an increase of either 25% or 0.5 mg/dL (44.2 μmol/L) in serum creatinine within 72 hours after contrast infusion. A simple CIN risk score based on independent predictors was established. Four variables were identified for our risk score model: LVEF < 40%, acute coronary syndrome (ACS), eGFR < 60, and contrast volume > 300 mL. Based on this new CIN risk score, the incidence of CIN had a significant trend with increased predicting score values of 5.9%, 32.9% and 60.0%, corresponding to low-, moderate- and high-risk groups, respectively. The novel risk assessment exhibited moderate discrimination ability for predicting CIN, with an AUC of 0.759 [95% CI 0.668-0.852, P = .001] in the validation cohort. It also had similar prognostic values for one-year follow-up MACE (C-statistic: 0.705 and 0.606 for new risk score and Mehran score, respectively). This novel risk prediction model could be effective for preventing nephropathy in diabetic patients receiving contrast media during surgical procedures.
['Yao|Zhi-Feng|ZF|https://orcid.org/0000-0001-8686-3728', 'Shen|Hong|H|', 'Tang|Min-Na|MN|', 'Yan|Yan|Y|', 'Ge|Jun-Bo|JB|']
D054058:Acute Coronary Syndrome D000368:Aged D003287:Contrast Media D003324:Coronary Artery Disease D016208:Databases, Factual D003661:Decision Support Techniques D003920:Diabetes Mellitus D005260:Female D006801:Humans D015994:Incidence D007674:Kidney Diseases D008297:Male D008875:Middle Aged D062645:Percutaneous Coronary Intervention D011237:Predictive Value of Tests D011897:Random Allocation D015203:Reproducibility of Results D012189:Retrospective Studies D018570:Risk Assessment D012307:Risk Factors D013318:Stroke Volume D016896:Treatment Outcome D016277:Ventricular Function, Left
contrast-induced nephropathy percutaneous coronary intervention risk scores major adverse cardiovascular events