Incidence and Associated factors with Contrast-Induced Nephropathy after Emergency Percutaneous Coronary Intervention in Patients with ST-segment Elevation Myocardial Infarction
Keywords:
contrast-induced nephropathy, myocardial infarction, coronary artery interventionAbstract
This study aimed to investigate the incidence and factors associated with Contrast-Induced Nephropathy (CIN) in patients with ST-segment Elevation Myocardial Infarction (STEMI) who underwent emergency Percutaneous Coronary Intervention (PCI) in the Thai population following the administration of contrast media (CM). The research was conducted retrospectively on 280 patients who experienced a creatinine level increase of more than 25% or exceeding 0.5 mg/dl. within 48-72 hours after receiving CM agents. Simple and multiple binary logistic regression analyses were employed to predict factors associated with CIN following contrast media exposure. Crude and Adjusted Odds Ratios (AOR) with 95% confidence intervals (CI) were utilized to demonstrate the associations between independent factors and CIN. The results revealed an incidence of CIN of 16.4%. Factors associated with CIN included CM volume exceeding 160 ml (AOR 4.66, 95%CI: 2.02-10.71, p<.001); heart failure (AOR 4.43, 95%CI: 1.80-10.93, p=.001); hypertension (AOR 4.34, 95%CI: 1.37-13.71, p=.013); anemia (AOR 3.95, 95%CI: 1.73-8.99, p=.001); and patients receiving antibiotic therapy (AOR 5.33, 95%CI: 2.32- 12.26, p<.001). The study findings provide insights into the incidence of CIN and associated factors, serving as guidelines for screening and ensuring safe patient care in the future.
Downloads
References
Sun G, Chen P, Wang K, Li H, Chen S, Liu J, et al. Contrast-induced nephropathy and long-term mortality after percutaneous coronary intervention in patients with acute myocardial infarction. Angiology. 2019;70(7): 621-6.
Silvain J, Nguyen LS, Spagnoli V, Kerneis M, Guedeney P, Vignolles N, et al. Contrastinduced acute kidney injury and mortality in ST elevation myocardial infarction treated with primary percutaneous coronary intervention. Heart. 2018;104(9): 767-72.
He H, Chen X-R, Chen Y-Q, Niu T-S, & Liao Y-M. PrevalenceandPredictorsofContrast-Induced Nephropathy(CIN)inPatientswithST-Segment Elevation Myocardial Infarction (STEMI) Undergoing Percutaneous Coronary Intervention (PCI): A Meta-Analysis. Journal of Interventional Cardiology. 2019;2019 e2750173.
Khalfallah M, Allaithy A, & Maria DA. Incidence, Predictors and Outcomes of Contrast Induced Nephropathy in Patients with ST Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Global Heart. 2021;16(1): e57.
Faggioni M, & Mehran R. Preventing Contrastinduced Renal Failure: A Guide. Interventional Cardiology Review. 2016;11(2): 98-104.
Mehran R, & Nikolsky E. Contrast-induced nephropathy: Definition, epidemiology, and patients at risk. Kidney International Journal. 2006;69: e11-5.
Legnazzi M, & Agnello F, & Capodanno D. Prevention of contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention. Kardiologia Polska (Polish Heart Journal). 2020;78(10): 967-73.
Shams E, & Mayrovitz HN. Contrast-induced nephropathy: a review of mechanisms and risks. Cureus. 2021;13(5): e14842.
Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, et al. 2021 ACC/ AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2022;79(2): e21-e129.
Bohplian S UP. Nurses’ Roles in Decreasing Delay Access to Treatment in Acute Coronary Syndrome Patients. Journal of Royal Thai Army Nurses. 2014;15(2): 78-83. (In Thai)
Samsky MD, Morrow DA, Proudfoot AG, Hochman JS, Thiele H, & Rao SV. Cardiogenic shock after acute myocardial infarction: a review. Journal of the American Medical Association. 2021;326(18): 1840-50.
Liu Y, Li H, Chen S, Chen J, Tan N, Zhou Y, et al. Excessively High Hydration Volume May Not Be Associated With Decreased Risk of Contrast-Induced Acute Kidney Injury After Percutaneous Coronary Intervention in Patients With Renal Insufficiency. Journal of the American Heart Association. 2016;5(6): e003171.
Maioli M, Toso A, Leoncini M, Micheletti C, & Bellandi F. Effects of Hydration in Contrast-Induced Acute Kidney Injury After Primary Angioplasty. Circulation: Cardiovascular Interventions. 2011;4(5): 456-62.
Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with STsegment elevation of the European Society of Cardiology (ESC). European Heart Journal. 2018;39(2): 119-77.
Almendarez M, Gurm HS, Mariani J, Montorfano M, Brilakis ES, Mehran R, et al. Procedural strategies to reduce the incidence of contrast-induced acute kidney injury during percutaneous coronary intervention. JACC: Cardiovascular Interventions. 2019;12(19): 1877-88.
Liu C, Caughey MC, Smith SC, & Dai X. Elevated left ventricular end diastolic pressure is associated with increased risk of contrastinduced acute kidney injury in patients undergoing percutaneous coronary intervention. International Journal of Cardiology. 2020;306: e196-e202.
Cho E, Ko G-J. The Pathophysiology and the Management of Radiocontrast-Induced Nephropathy. Diagnostics. 2022;12(1): e180.
Mamoulakis C, Tsarouhas K, Fragkiadoulaki I, Heretis I, Wilks MF, Spandidos DA, et al. Contrast-induced nephropathy: Basic concepts, pathophysiological implications and prevention strategies. Pharmacology & therapeutics. 2017;180(1): 99-112.
McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. European Heart Journal. 2021;42(36): 3599-726.
Giancarlo M, Nicola C, & Antonio LB. Acute kidney injury in patients with acute coronary syndromes. Heart. 2015;101(22): 1778-85.
Abellás-Sequeiros R, Raposeiras-Roubín S, A bu - A ss i E , González-Salvado V , Iglesias-Álvarez D, Redondo-Diéguez A, et al. Mehran contrast nephropathy risk score: is it still useful 10 years later? Journal of Cardiology. 2016;67(3): 262-67.
Ameer OZ. Hypertension in chronic kidney disease: What lies behind the scene. Frontiers in Pharmacology. 2022;13: e949260.
Rakowski T, Dziewierz A, Wegiel M, Siudak Z, Zasada W, Jakała J, et al. Risk factors of contrast-induced nephropathy in patients with acute coronary syndrome. Kardiologia Polska (Polish Heart Journal). 2022;80(7): 760-4.
Sreenivasan J, Zhuo M, Khan MS, Li H, Fugar S, Desai P, et al. Anemia (hemoglobin≤ 13 g/dL) as a risk factor for contrast-induced acute kidney injury following coronary angiography. The American Journal of Cardiology. 2018;122(6): 961-5.
Liang W, Yu CJ, Wang QY, & Yu J. Anemia is associated with increased risk of contrastinduced acute kidney injury: A Systematic Review and Meta-analysis. Bioengineered. 2021;12(1): 648-61.
Ishii H. Coronary stent infection: A catastrophic complication after percutaneous coronary intervention. International Journal of Cardiology. 2021;344: e82-3.
Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Critical care medicine. 2021;47(11): 1181-247.
Campbell RE, Chen CH, & Edelstein CL. Overview of Antibiotic-Induced Nephrotoxicity. Kidney International Reports. 2023;8(11): 2211-25.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Journal of The Royal Thai Army Nurses
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความหรือข้อคิดเห็นใดใดที่ปรากฏในวารสารพยาบาลทหารบกเป็นวรรณกรรมของผู้เขียน ซึ่งบรรณาธิการหรือสมาคมพยาบาลทหารบก ไม่จำเป็นต้องเห็นด้วย
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารพยาบาลทหารบก
The ideas and opinions expressed in the Journal of The Royal Thai Army Nurses are those of the authors and not necessarily those
of the editor or Royal Thai Army Nurses Association.
