Association Between Contrast Media Volume-Glomerular Filtration Rate Ratio and Contrast-Induced Acute Kidney Injury After Primary Percutaneous Coronary Intervention

Angiology. 2015 Jul;66(6):519-24. doi: 10.1177/0003319714542277. Epub 2014 Jul 8.

Abstract

We hypothesized that contrast media volume-estimated glomerular filtration rate (CV-e-GFR) ratio may be a predictor of contrast media-induced acute kidney injury (CI-AKI). We investigated the associations between CV-e-GFR ratio and CI-AKI in 597 patients undergoing primary percutaneous coronary intervention (pPCI). An absolute ≥0.3 mg/dL increase in serum creatinine compared with baseline levels within 48 hours after the procedure was considered as CI-AKI; 78 (13.1%) of the 597 patients experienced CI-AKI. The amount of contrast during procedure was higher in the CI-AKI group than in those without CI-AKI (153 vs 135 mL, P = .003). The CV-e-GFR ratio was significantly higher in patients with CI-AKI than without (2.3 vs 1.5, P < .001). In multivariate analysis, independent predictors of CI-AKI were low left ventricular ejection fraction (P = .018, odds ratio [OR] = 0.966), e-GFR <60 mL/min (P = .012, OR = 2.558), and CV-e-GFR >2 (P < .001, OR = 5.917). In conclusion, CV-e-GFR ratio is significantly associated with CI-AKI after pPCI.

Keywords: contrast media volume–estimated glomerular filtration ratio; contrast-induced acute kidney injury; primary percutaneous coronary intervention.

MeSH terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / physiopathology
  • Aged
  • Biomarkers / blood
  • Chi-Square Distribution
  • Contrast Media / adverse effects*
  • Coronary Angiography / adverse effects
  • Creatinine / blood
  • Female
  • Glomerular Filtration Rate / drug effects*
  • Humans
  • Kidney / drug effects*
  • Kidney / physiopathology
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy*
  • Odds Ratio
  • Percutaneous Coronary Intervention / adverse effects*
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors
  • Stroke Volume
  • Time Factors
  • Treatment Outcome
  • Up-Regulation
  • Ventricular Function, Left

Substances

  • Biomarkers
  • Contrast Media
  • Creatinine