CHA2DS2-VASc, a Simple Clinical Score Expanding Its Boundaries To Predict Contrast Induced Acute Kidney Injury After Primary Percutaneous Coronary Interventions

Abstract

Background Promising results of CHA2DS2-VASc score have been reported for the prediction of contrast induced nephropathy (CIN) after percutaneous coronary intervention (PCI). However, data of its predictive strength in the context of primary PCI is not available. Therefore, in this study, we have assessed predictive value of CHA2DS2-VASc score for CIN after primary PCI. Methodology : This analytical cross-sectional study was conducted between January 2021 and June 2021 at the National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan. Inclusion criteria of the study was consecutive adult patients undergone primary PCI. Baseline CHA2DS2-VASc score was calculated and either 25% or 0.5 mg/dL increase in post-procedure serum creatinine level as compared to baseline level was categorized as CIN. Results A total of 691 patients were included, of which 82.1% (567) were male. CIN after primary PCI was observed in 63 (9.1%) patients out of which 66.7% (42) patients had CHA2DS2-VASc score of ≥ 2. The area under the curve (AUC) for the score was 0.725 [0.662 to 0.788] with sensitivity and specificity of 66.7% [63.1–70.2%] and 66.7% [53.7–78.1%] respectively at cut-off value of ≥ 2. In multivariable analysis, left ventricular ejection fraction ≤ 30% and CHA2DS2-VASc ≥ 2 were found to be independent predictors with adjusted odds ratios of 2.19 [1.06–4.5] and 2.13 [1.13–4.01] respectively. Conclusions CHA2DS2-VASc score has good predictive value for the prediction of CIN after primary PCI. Criteria of CHA2DS2-VASc ≥ 2 can be used for the risk stratification of CIN after primary PCI.