CONTRAST-INDUCED ACUTE KIDNEY INJURY: THE SIN OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION

Abstract

Objective: To determine frequency of contrast-induced nephropathy (CIN), andpost procedure complications in-hospital mortality in patients after undergoingPrimary Percutaneous Coronary Intervention for acute ST-Elevation MyocardialInfarction (STEMI).

Methodology: This cross sectional study includes patients, who underwentprimary percutaneous coronary intervention at NICVD Karachi from 8th October2016 to 7th April 2017. Rise of at least 0.5 mg/dL in serum creatinine level or a25% increase from baseline within forty-eight to seventy-two hours after contrastadministration was used as criteria for contrast induced nephropathy.Demographic characteristics, clinical history, presentation, post proceduralcomplications, and in-hospital mortality in CIN and non-CIN group wereassessed and compared.

Results: Of 282 patients 69.86% (197) were males with mean age of 54.77 ±11.18 years. Contrast-induced nephropathy was observed in 12.41% (35)patients. Proportion of female patients was significantly higher in CIN group.Diabetes, hypertension and CKD remain the major risk factors. Amount ofcontrast used, serum creatinine, length of hospital stay, and mortality weresignificantly higher in CIN group. After the adjustments for potential effectmodifiers the only statistically significant factors were found to be female genderand contrast used 200ml (p= 0.012 and 0.01 respectively).

Conclusion: CIN after primary PCI is strongly and positively associated withfemale gender, hypertension, chronic kidney disease, diabetes mellitus,presence of shock and more than 200 ml of contrast use.

Key Words: Contrast induced nephropathy, Primary PCI, ST-segment elevationmyocardial infarction.