B-type Natriuretic Peptide and Risk of Contrast-Induced Acute Kidney Injury in Acute ST-Segment–Elevation Myocardial Infarction

Járai, Rudolf; Dangas, George; Huber, Kurt; Xu, Ke; Brodie, Bruce R.; Witzenbichler, Bernhard; Metzger, D. Christopher; Radke, Peter W.; Yu, Jennifer; Claessen, Bimmer E.; Généreux, Philippe; Mehran, Roxana; Stone, Gregg W.

doi:10.1161/circinterventions.112.972356

Cited by 46 publications

(42 citation statements)

References 38 publications

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“…As shown in Figure 2, there was a graded decline in CV use among patients with SYNTAX score of <22, 22 to 32, and > 32. As discussed previously, 2 studies 1,21 have proposed a greater CV in patients with left compared to right coronary lesions; this association may be related to the increased absolute number of the epicardial vessels in the left compared to the right coronary system. Compared to the description of a coronary lesion by location, the SYNTAX score provides a more comprehensive assessment of lesion complexity.…”

Section: Discussionmentioning

confidence: 83%

Do Cardiovascular Risk Factors and Coronary SYNTAX Score Predict Contrast Volume Use During Cardiac Catheterization?

et al. 2015

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The association of cardiovascular risk factors and complexity and severity of coronary artery disease with contrast volume (CV) remains unknown. We assessed the predictive factors of CV use during elective and emergent cardiac catheterization (CC). Electronic medical records from 2010 to 2013 were retrospectively reviewed. A total of 708 patients were eligible. On multivariable regression analysis, the presence of obstructed coronary arteries was associated with CV (P = .01, β = -14.17), with greater CV used in patients with single or double vessel disease compared to those with triple vessel disease. The presence of lesions with >70% stenosis in major epicardial arteries (P = .019, β = 24.39) and ST-segment elevation myocardial infarction (P = .001, β = 36.14) was associated with increased CV use. Elevated B-type natriuretic peptide (P = .036, β = -17.23) and increase in Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score (P = .024, β = -29.06) were associated with decreased CV use. These aforementioned associations were attenuated after adjusting for percutaneous coronary intervention. Our findings may help predict patient populations who could be exposed to increased CV during CC, thereby possibly increasing their risk of contrast-induced nephropathy.

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Section: Discussionmentioning

confidence: 83%

Do Cardiovascular Risk Factors and Coronary SYNTAX Score Predict Contrast Volume Use During Cardiac Catheterization?

et al. 2015

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“…One recent study, 10 a substudy of the HORIZONS‐AMI trial, focused on the correlation between BNP and the risk of CIN in patients with acute ST‐segment elevation myocardial infarction (odds ratio: 1.29, 95% CI: 1.10 to 1.51; P <0.001); however, BNP and serial creatinine levels suitable for complete measurement were only available in 979 of the 3602 patients enrolled (27.2%) and were not sufficient to determine an optimal BNP cutoff concentration for the prediction of CIN. Another study indicated that preoperative BNP level is associated with postoperative acute kidney injury in high‐risk patients undergoing cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Preprocedural N‐Terminal Pro‐Brain Natriuretic Peptide (NT‐proBNP) Is Similar to the Mehran Contrast‐Induced Nephropathy (CIN) Score in Predicting CIN Following Elective Coronary Angiography

Liu

Tan

et al. 2015

JAHA

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BackgroundN‐terminal pro‐brain natriuretic peptide (NT‐proBNP) has been associated with important risk factors for contrast‐induced nephropathy (CIN). However, few studies have investigated the predictive value of NT‐proBNP itself. This study investigated whether levels of preprocedural NT‐proBNP could predict CIN after elective coronary angiography as effectively as the Mehran CIN score.Methods and ResultsWe retrospectively observed 2248 patients who underwent elective coronary angiography. The predictive value of preprocedural NT‐proBNP for CIN was assessed by receiver operating characteristic and multivariable logistic regression analysis. The 50 patients (2.2%) who developed CIN had higher Mehran risk scores (9.5±5.1 versus 4.8±3.8), and higher preprocedural levels of NT‐proBNP (5320±7423 versus 1078±2548 pg/mL, P<0.001). Receiver operating characteristic analysis revealed that NT‐proBNP was not significantly different from the Mehran CIN score in predicting CIN (C=0.7657 versus C=0.7729, P=0.8431). An NT‐proBNP cutoff value of 682 pg/mL predicted CIN with 78% sensitivity and 70% specificity. Multivariable analysis suggested that, after adjustment for other risk factors, NT‐proBNP >682 pg/mL was significantly associated with CIN (odds ratio: 4.007, 95% CI: 1.950 to 8.234; P<0.001) and risk of death (hazard ratio: 2.53; 95% CI: 1.49 to 4.30; P=0.0006).ConclusionsPreprocedural NT‐proBNP >682 pg/mL was significantly associated with the risk of CIN and death. NT‐proBNP, like the Mehran CIN score, may be another useful and rapid screening tool for CIN and death risk assessment, identifying subjects who need therapeutic measures to prevent CIN.

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“…In our study, however, left ventricular ejection fraction on admission was not available for all patients. Therefore, we examined BNP on admission, which can be regarded as an objective measure of left ventricular performance [35].…”

Section: Discussionmentioning

confidence: 99%

Combined impact of chronic kidney disease and contrast-induced nephropathy on long-term outcomes in patients with ST-segment elevation acute myocardial infarction who undergo primary percutaneous coronary intervention

et al. 2016

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Contrast-induced nephropathy (CIN) and chronic kidney disease (CKD) are associated with poor outcomes after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI); however, its combined prognostic significance remains unclear. We enrolled 577 patients with AMI undergoing primary PCI within 12 h after symptom onset and measured serum creatinine on admission and the next 3 days. CKD was defined as admission estimated glomerular filtration rate <60 ml/min/1.73 m, and CIN was defined as creatinine increase ≥0.5 mg/dl or ≥25 % from baseline within the first 72 h. Patients were stratified according to the presence or absence of CKD and CIN. In patients with no CKD and no CIN (n = 244), no CKD but CIN (n = 152), CKD but no CIN (n = 127), and both CKD and CIN (n = 54), the 3-year major adverse cardiovascular events (MACE: a combination of all-cause mortality, nonfatal reinfarction, or heart failure requiring rehospitalization) were 8, 9, 13, and 35 %, respectively (p < 0.001). Multivariate analysis showed that as compared with no CKD and no CIN, hazard ratios (95 % CI) for MACE associated with no CKD but CIN, CKD but no CIN, and both CKD and CIN were 0.91 (0.44-1.84; p = 0.79), 1.11 (0.5-2.23; p = 0.77), and 2.98 (1.48-6.04; p = 0.002), respectively. In patients with AMI undergoing primary PCI, the combination of CKD and CIN is significantly associated with adverse long-term outcomes.

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B-type Natriuretic Peptide and Risk of Contrast-Induced Acute Kidney Injury in Acute ST-Segment–Elevation Myocardial Infarction

Cited by 46 publications

References 38 publications

Do Cardiovascular Risk Factors and Coronary SYNTAX Score Predict Contrast Volume Use During Cardiac Catheterization?

Do Cardiovascular Risk Factors and Coronary SYNTAX Score Predict Contrast Volume Use During Cardiac Catheterization?

Preprocedural N‐Terminal Pro‐Brain Natriuretic Peptide (NT‐proBNP) Is Similar to the Mehran Contrast‐Induced Nephropathy (CIN) Score in Predicting CIN Following Elective Coronary Angiography

Combined impact of chronic kidney disease and contrast-induced nephropathy on long-term outcomes in patients with ST-segment elevation acute myocardial infarction who undergo primary percutaneous coronary intervention

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