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Objective
Promising results of CHA2DS2-VASc score have been reported for the prediction of contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI). However, data of its predictive strength in the context of primary PCI are not available. Therefore, in this study, we have assessed predictive value of CHA2DS2-VASc...
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Context 1
... mortality rate was significantly higher in patients with CI-AKI with a mortality rate of 6.3% (4) vs 1.4% (9); p = 0.006 as compared to the non-CI-AKI group respectively. Similarly, post-procedure complications such as slow flow/no-reflow (41.3% (26) vs 15.9% (100); p < 0.001), arrhythmias needing pharmacotherapy (9.5% (6) vs 1.1% (7); p < 0.001), cardiogenic shock (4.8% (3) vs 0.8% (5); p = 0.005), stroke (1.6% (1) vs 0% (0); p = 0.002), and reinfarction (3.2% (2) vs 0.3% (2); p = 0.004) were significantly higher among the CI-AKI group as compared to the non-CI-AKI group respectively (Table 1). ...Similar publications
Introduction
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Citations
... On the other hand, a CHA 2 DS 2 -VASc score ≥ 2 was found as an independent predictor of CIN development in STEMI similar to our results. 31 The CHA 2 DS 2 -VASc score was found more sensitive than the CHADS 2 score in terms of predicting stroke risk. 32 Although these risk scores were created mainly to predict thromboembolism in atrial fibrillation, the CHA 2 DS 2 -VASc score was shown to estimate adverse events in those with chronic coronary syndromes, ACS, sick sinus syndrome, CHF and patients with Takotsubo syndrome. ...
Objective:
Contrast-induced nephropathy (CIN) is one of the well-known complications of cardiac catheterization and related with in-hospital and long-term morbidity and mortality. We aimed to evaluate if CHA2DS2-VASc score can also be used as a surrogate for CIN development and moreover the relationship between CIN development and in-hospital major adverse cardiac events (MACE) in patients presenting with STEMI and undergoing primary PCI.
Methods:
All patients presented with STEMI and underwent primary PCI between 2015-2019 in our center were included retrospectively.
Results:
A total of 572 patients were included. Age [P = 0.032, β: 0.153, odds ratio (95% CI): 0.014-0.302], diabetes mellitus [(P = 0.023, β: 0.134, odds ratio (95% CI): 0.017-0.217], history of stroke [P = 0.034, β: 0.118, OR (95% CI): 0.017-0.436], volume of contrast medium [P = 0.042, β: 0.155, OR (95% CI): 0.109-0.462], left ventricular ejection fraction [P = 0.003, β: 0.376, OR (95% CI): 0.214-0.517], and CHA2DS2-VASc score [P = 0.001, β: 0.115, OR (95% CI): 0.054-0.177] were detected as independent risk factors associated with contrast-induced nephropathy development. The area under the curve for CHA2DS2-VASc score was 0.809 (95% CI: 0.760-0.857). A cut-off value of 2.5 for CHA2DS2-VASc score was associated with 80.1% sensitivity and 71.4% specificity in the prediction of contrast-induced nephropathy development.
Conclusion:
Our current study showed that the CHA2DS2-VASc risk score has an effective discriminating power in determining the contrast-induced nephropathy development and a score ≥2 defines the group at risk in patients presenting with ST-elevation myocardial infarction and underwent primary percutaneous coronary intervention. Moreover, contrast-induced nephropathy development is associated with longer coronary care unit stay and major adverse cardiac events (in-hospital decompensated heart failure, cardiogenic shock, cardiac arrest, and mortality).
Background:
Promising results with the CHA2DS2-VASc risk score (CVRS) have been reported for the prediction of contrast-induced nephropathy (CIN). The aim of this study is to consolidate all the data available and examine the association between elevated CVRS and the incidence of CIN in patients undergoing percutaneous coronary intervention (PCI).
Methods:
We systematically searched PubMed, Embase, and Scopus for abstracts and full-text articles from inception to May 2022. Studies were included if they evaluated the association between a high CVRS and the incidence of CIN in patients undergoing PCI. Data were integrated using the random-effects, generic inverse variance method of DerSimonian and Laird. Prospero registration: CRD42022334065.
Results:
Seven studies from 2016 to 2021 with a total of 7,401 patients were included. In patients undergoing PCI, a high CVRS (≥2: Odds ratio [OR]:2.98, 95% confidence interval [95% CI] 2.25-3.94, p < .01, I2 = 1%, ≥3: OR 4.46, 95% CI 2.27-8.78, p < .01, I2=56% and ≥4: OR:2.75, 95% CI 1.76-4.30, p < .01, I2 = 11%) was significantly associated with an increase incidence for CIN. Subgroup analyses were done in patients with acute coronary syndrome, and association with CIN remained statistically significant (≥2: OR 2.93, 95% CI 2.11-4.07, p < .01, I2=22%and ≥4: OR:2.24, 95% CI 1.36-3.69, p < .01, I2 = 0%,).
Conclusion:
In patients undergoing PCI, an elevated CVRS is associated with an increased risk for CIN. More rigorous studies are needed to clarify this association and to identify strategies to reduce CIN.
