VALIDITY OF MEHRAN RISK SCORE FOR PREDICTING CONTRAST INDUCED NEPHROPATHY IN MODERN PRIMARY PERCUTANEOUS CORONARY INTERVENTIONS ERA

Authors

  • Rajesh Kumar National Institute of Cardiovascular Diseases Karachi
  • Tarique Ahmed National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Shahzad Khatti
  • Aziz-ur Rehman Memon National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Naveed Ahmed Shaikh National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Fawad Farooq National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Zille Huma National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Sabir Hussain National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Jawaid Akbar Sial National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Tahir Saghir National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan

DOI:

https://doi.org/10.47144/phj.v55i1.2183

Abstract

Objectives: Contrast induced nephropathy (CIN) is a common complication and found to be associated with increased morbidity and mortality after primary percutaneous coronary intervention (PCI). The objective of this study was to validate the Mehran Risk Score (MRS) for the risk stratification of CIN in patients undergone primary PCI.

Methodology: A cohort of consecutive patients undergone primary PCI at a tertiary care cardiac center were included for this study. Patients in Killip class IV at presentation, patents history of any PCI, and chronic kidney diseases were excluded from this study. MRS was calculated at baseline and post procedure serum creatinine level increase of either 25% or 0.5 mg/dL was taken as CIN.

Results: A total of 547 patients were included, of which 79.3%(434) were male. CIN after primary PCI was observed in 62(11.3%) patients. The area under the curve (AUC) for the MRS was 0.712 [0.641 to 0.783]. Cut-off value of ≥6.5 had sensitivity of 61.3% [48.1%-73.4%] with positive predictive value of 21.2% [17.5%-25.6%] and specificity of 70.9% [66.7%-74.9%] with negative predictive value of 93.5% [91.3%-95.2%]. MRS ≥6.5 was found to be an independent predictor on multivariable analysis with adjusted odds ratios (OR) of 3.86 [2.23-6.68] along with multi-vessel diseases with OR of 2.31 [1.27-4.19].

Conclusion: MRS has shown to have a good discriminating power. However low positive predictive value of the optimal cutoff value of ≥6.5 for prediction of CIN suggests need of modification to the MRS to improve its clinical utility in the modern era of primary PCI.

Downloads

Download data is not yet available.

Downloads

Published

2022-03-25

How to Cite

1.
Kumar R, Ahmed T, Khatti S, Memon A- ur R, Shaikh NA, Farooq F, Huma Z, Hussain S, Sial JA, Saghir T. VALIDITY OF MEHRAN RISK SCORE FOR PREDICTING CONTRAST INDUCED NEPHROPATHY IN MODERN PRIMARY PERCUTANEOUS CORONARY INTERVENTIONS ERA. Pak Heart J [Internet]. 2022Mar.25 [cited 2024Mar.29];55(1):73-8. Available from: https://pakheartjournal.com/index.php/pk/article/view/2183

Issue

Section

Original Article