CHA2DS2-VASc score predicts contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction, who have undergone primary percutaneous coronary intervention

Çiçek, Gökhan; Yıldırım, Ersin

doi:10.5603/kp.a2017.0177

Cited by 18 publications

(13 citation statements)

References 24 publications

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“…In addition, the widely recognized risk factors of CIN at present also include age, diabetes, congestive heart failure, severe hypovolemia, dehydration, long-term sustained hypotension, multiple myeloma, osmotic pressure, volume and using interval time of contrast medium, etc. [21,22]. Our study have ruled out the objects with obvious hemodynamic instability, but we still did not find any significant difference in factors like diabetes and age between groups of CIN and no CIN, which means further more studies are needed.…”

Section: Discussionmentioning

confidence: 58%

Relationship between Preoperative Urinary Microalbumin to Creatinine Ratio Level and Contrast-induced Nephropathy after Elective Coronary Angiography/Percutaneous Coronary Intervention

Ma¹,

Tang²,

Qin³

et al. 2018

Angiol

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Objective: To investigate the predictive value of preoperative urinary microalbumin to creatinine ratio (UACR) level for early diagnosis of contrast-induced nephropathy (CIN). Methods:A total of 180 patients scheduled to undergo elective coronary angiography (CAG)/percutaneous coronary intervention (PCI) in our department from November 2016 to September 2017 were selected into this prospective study. Patients were allocated to high UACR group (UACR ≥ 30, n=35) and control group (UACR<30, n=145) according to the UACR level. The patients were also divided into CIN group (n=32) and no CIN group (n=148). Multivariable logistic regression model was used to investigate the risk factors of CIN. This trial was registered on the Chinese Clinical Trial Registry on 23 May 2017 (Registration No. ChiCTR-OOC-17011467).Results: 32 patients developed CIN (17.78%). The incidence of CIN was significantly higher in high UACR group than in the control group (P0.001). The ratio of high UACR in CIN group was significantly higher than no CIN group (P0.001). Multivariable logistic regression analysis indicated that preoperative UACR level (P0.001, 95%CI: 3.81929.223, OR: 10.564) was an independent risk factor of CIN. Conclusion:Preoperative UACR level appears to be an independent predictive factor for early diagnosis of CIN.

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Section: Discussionmentioning

confidence: 58%

Relationship between Preoperative Urinary Microalbumin to Creatinine Ratio Level and Contrast-induced Nephropathy after Elective Coronary Angiography/Percutaneous Coronary Intervention

Ma¹,

Tang²,

Qin³

et al. 2018

Angiol

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“…It is very simple and broadly known and used by clinicians. Several studies have confirmed the usefulness of this score in predicting outcomes, including in patients who do not have AF [13–17]. The impact of the CHA 2 DS 2 -VASc score on clinical outcomes in patients with MI has been reported.…”

Section: Discussionmentioning

confidence: 93%

CHA2DS2-VASc and R2-CHA2DS2-VASc scores predict in-hospital and post-discharge outcome in patients with myocardial infarction

Węgiel¹,

Rakowski

Dziewierz

et al. 2018

pwki

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IntroductionThe CHA2DS2-VASc and R2-CHA2DS2-VASc scores were initially designed to evaluate the risk of cerebrovascular events in patients with atrial fibrillation. However, these scales consist of parameters which are well known as general risk factors for cardiovascular events.AimTo assess the role of the CHA2DS2-VASc and R2-CHA2DS2-VASc scores in predicting outcome of patients with myocardial infarction (MI).Material and methodsWe enrolled 212 consecutive patients with both ST-elevation and non-ST-elevation MI referred for primary percutaneous coronary intervention (PCI). Patients were divided into two groups depending on the CHA2DS2-VASc score: ≤ 3 (low score) and > 3 points (high score).ResultsThe group with a CHA2DS2-VASc score > 3 points consisted of 93 (44%) patients. Follow-up was available in 200 (94.3%) patients with median duration of 10 (Q1: 6; Q3: 13) months. During the follow-up all-cause mortality was greater in patients from the high score group (21%) compared to patients with lower scores (8%) (p = 0.009). Recurrent MI was found in 4% of patients from the low score group and in 13% of patients from the high score group (p = 0.024). The combined endpoint of cardiovascular mortality, recurrent non-fatal MI and non-fatal stroke occurred in 13% of lower score patients and in 30% of patients with a score > 3 points (p = 0.002). In a Cox regression model both scores were predictors of all-cause mortality with a hazard ratio of 1.31 per 1 point increase for the CHA2DS2-VASc score (p = 0.004) and 1.36 for the R2-CHA2DS2-VASc score (p < 0.001).ConclusionsThe CHA2DS2-VASc and R2-CHA2DS2-VASc scores predict in-hospital and post-discharge outcome in patients with acute MI undergoing primary PCI.

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“…The CHA2DS2-VASC risk score (CVRS) and the Global Registry for Acute Coronary Events (Grace) were also used to predict CI-AKI. Yong Wang and colleagues found that CVRS, developed for stratification of embolic risk in patients with atrial fibrillation (AF) to provide further optimized anticoagulant therapy, can be used as a simple preoperative predictor of CI-AKI in patients with CTO undergoing PCI (C-statistic =0.742) [42], which was also confirmed in patients with acute STelevation myocardial infarction and acute coronary syndrome [43][44][45]. In addition, the Grace score was also considered to be a strong predictor of CI-AKI development in patients [46,47].…”

Section: Discussionmentioning

confidence: 99%

Validation of pre-operative risk scores of contrast-induced acute kidney injury in a Chinese cohort

Zhang

Zhou

et al. 2020

BMC Nephrol

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Background: Pre-operative risk scores are more valuable than post-procedure risk scores because of lacking effective treatment for contrast-induced acute kidney injury (CI-AKI). A number of pre-operative risk scores have been developed, but due to lack of effective external validation, most of them are also difficult to apply accurately in clinical practice. It is necessary to review and validate the published pre-operative risk scores for CI-AKI. Materials and methods: We systematically searched PubMed and EMBASE databases for studies of CI-AKI preoperative risk scores and assessed their calibration and discriminatory in a cohort of 2669 patients undergoing coronary angiography or percutaneous coronary intervention (PCI) from September 2007 to July 2017. The definitions of CI-AKI may affect the validation results, so three definition were included in this study, CI-AKI broad1 was defined as an increase in serum creatinine (Scr) of 44.2 μmol/L or 25%; CI-AKI broad2, an increase in Scr of 44.2 μmol/L or 50%; and CI-AKI-narrow, an increase in Scr of 44.2 μmol/L. The calibration of the model was assessed with the Hosmer-Lemeshow test and the discriminatory capacity was identified by C-statistic. Results: Of the 8 pre-operative risk scores for CI-AKI identified, 7 were single-center study and only 1 was based on multi-center study. In addition, 7 of the scores were just validated internally and only Chen score was externally validated. In the validation cohort of 2669 patients, the incidence of CI-AKI ranged from 3.0%(Liu) to 16.4%(Chen) for these scores. Furthermore, the incidence of CI-AKI was 6.59% (178) for CI-AKI broad1, 1.44% (39) for CI-AKI broad2, and 0.67% (18) for CI-AKI-narrow. For CI-AKI broads, C-statistics varied from 0.44 to 0.57. For CI-AKI-narrow, the Maioli score had the best discrimination and calibration, what's more, the C-statistics of Maioli, Chen, Liu and Ghani was ≥0.7. Conclusion: Most pre-operative risk scores were established based on single-center studies and most of them lacked external validation. For CI-AKI broads, the prediction accuracy of all risk scores was low. The Maioli score had the best discrimination and calibration, when using the CI-AKI-narrow definition.

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CHA2DS2-VASc score predicts contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction, who have undergone primary percutaneous coronary intervention

Cited by 18 publications

References 24 publications

Relationship between Preoperative Urinary Microalbumin to Creatinine Ratio Level and Contrast-induced Nephropathy after Elective Coronary Angiography/Percutaneous Coronary Intervention

Relationship between Preoperative Urinary Microalbumin to Creatinine Ratio Level and Contrast-induced Nephropathy after Elective Coronary Angiography/Percutaneous Coronary Intervention

CHA2DS2-VASc and R2-CHA2DS2-VASc scores predict in-hospital and post-discharge outcome in patients with myocardial infarction

Validation of pre-operative risk scores of contrast-induced acute kidney injury in a Chinese cohort

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