Comparative analysis of four established risk scores for predicting contrast induced acute kidney injury after primary percutaneous coronary interventions

Kumar, Rajesh; Khan, Kamran Ahmed; Rai, Lajpat; Solangi, Bashir Ahmed; Ammar, Ali; Khan, M. Gabriel; Ahmed, Ifikhar; Ahmed, Bilal; Saghir, Tahir; Sial, Jawaid Akbar; Karim, Musa

doi:10.1016/j.ijcha.2021.100905

Cited by 2 publications

(4 citation statements)

References 29 publications

(43 reference statements)

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“…16 In a study, discriminative power of the C-ACS score was reported to be comparable as that of the MRS with AUC of 0.822 vs. 0.751 respectively. 15 However, results of our study were not as supportive as results of Liu Y-H et al 15 , a recent study by Kumar R et al 14 Our study has some limitations, first and foremost due to a small number of events, multivariable association analysis could not be performed. Secondly, CIN was defined based on variations in serum creatinine level, more direct assessment of kidney function such as kidney morphology and proteinuria and use of imaging modalities would have increased the accuracy of assessment.…”

Section: Discussioncontrasting

confidence: 92%

“…5,12 Although, a number of scoring systems have been introduced but the most established one is the Mehran risk score (MRS). 13 It has been also recently validated by the Kumar R et al 14 in the STEMI patients. The Canada Acute Coronary Syndrome (C-ACS) score is among other most commonly used scoring system, simplicity of its computation makes it a potential candidate for the CIN risk stratification in the context of primary PCI.…”

Section: Introductionmentioning

confidence: 97%

“…The Canada Acute Coronary Syndrome (C-ACS) score is among other most commonly used scoring system, simplicity of its computation makes it a potential candidate for the CIN risk stratification in the context of primary PCI. 14,15 It has been reported to have significant role in CIN risk assessment due to the fact that all of its components, age, congestive heart failure, and hemodynamic variations, are by on their own are the important predictors of CIN. 16 Therefore, aim of this study was to evaluate and compare the predictive value of C-ACS score against MRS for the prediction of the development of CIN in STEMI patients after primary PCI at a tertiary care cardiac hospital.…”

Section: Introductionmentioning

confidence: 99%

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Significance of Canada Acute Coronary Syndrome Risk Score in Emergency Percutaneous Revascularization for the Prediction of Contrast Induced Nephropathy

Kumar,

Naqvi,

Kumari

et al. 2022

Pak Heart J

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Objectives: This study was conducted to compare the accuracy of Canada Acute Coronary Syndrome (C-ACS) score against Mehran risk score (MRS) in primary percutaneous coronary intervention (PCI) patients for risk stratification of contrast induced nephropathy (CIN) at a tertiary care cardiac hospital. Methodology: In this study we included adult patients presented with chief presenting complaint of typical chest pain to emergency department within 12 hours of onset of symptoms, diagnosed with ST-segment elevation myocardial infarction (STEMI) and taken to the catheterization laboratory for primary PCI. Two scores MRS and C-ACS were computed and CIN was defined based on the variations in creatinine level, absolute 0.5 mg/dL or relative 25% increase at 48-72 hours. Results: Study included a total of 593 patients with mean age of 52.22±11.1 years and 488(82.3%) were male patients. A total of 53(8.9%) patients developed CIN after primary PCI. The area under the curve (AUC) was 0.745 [0.675-0.815] and 0. 647 [0.560-0.733] for MRS and C-ACS score respectively. The threshold value C-ACS ≥ 1 has sensitivity of 47.2% [33.3%-61.4%] and specificity of 80.2% [76.6%-83.5%]. Similarly, MRS ≥6.5 has sensitivity of 64.2% [49.8%-76.9%] and specificity of 75% [71.1%-78.6%]. Conclusion: C-ACS score is found to be less sensitive but more specific in identifying patients at high risk of CIN. Predictive value of C-ACS was observed to be lower than that of MRS. In the tradeoff of simplicity and accuracy, clinicians may consider accuracy and prefer MRS over C-ACS for the risk stratification of CIN.

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Section: Discussioncontrasting

confidence: 92%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Significance of Canada Acute Coronary Syndrome Risk Score in Emergency Percutaneous Revascularization for the Prediction of Contrast Induced Nephropathy

Kumar,

Naqvi,

Kumari

et al. 2022

Pak Heart J

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“… 24 Furthermore, CI-AKI is considered to be largely associated with baseline renal function, however, CHA 2 DS 2 -VASC score is independent of baseline kidney function therefore, it can be an effective tool for patients without pre-existing renal conditions. 25 However, a recent study by Kumar et al 26 reported CHA 2 DS 2 -VASc score to have poor discriminating power as compared to the MRS in contrast to the earlier studies in ACS patients. Therefore, this study was designed to assess the predictive value of CHA 2 DS 2 -VASc score for CI-AKI after primary PCI among patients with STEMI presented to a tertiary care cardiac center of Karachi, Pakistan.…”

Section: Introductionmentioning

confidence: 92%

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

Kumar¹,

Batra²,

Khowaja³

et al. 2021

IJNRD

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Objective Promising results of CHA 2 DS 2 -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 CHA 2 DS 2 -VASc score for CI-AKI after primary PCI. Methods 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 who had undergone primary PCI. Baseline CHA 2 DS 2 -VASc score was calculated, and either a 25% or 0.5 mg/dL increase in post-procedure serum creatinine level as compared to baseline level was categorized as CI-AKI. Results A total of 691 patients were included, of which 82.1% (567) were male. CI-AKI after primary PCI was observed in 63 (9.1%) patients, out of which 66.7% (42) of patients had CHA 2 DS 2 -VASc score of ≥2. The area under the curve (AUC) for the score was 0.725 [0.662 to 0.788] with a sensitivity and specificity of 66.7% [63.1% to 70.2%] and 66.7% [53.7% to 78.1%], respectively, at a cut-off value of ≥2. In multivariable analysis, left ventricular ejection fraction ≤30% and CHA 2 DS 2 -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. Conclusion CHA 2 DS 2 -VASc score has a good predictive value for the prediction of CI-AKI after primary PCI. Criteria of CHA 2 DS 2 -VASc ≥2 can be used for the risk stratification of CI-AKI after primary PCI.

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Comparative analysis of four established risk scores for predicting contrast induced acute kidney injury after primary percutaneous coronary interventions

Cited by 2 publications

References 29 publications

Significance of Canada Acute Coronary Syndrome Risk Score in Emergency Percutaneous Revascularization for the Prediction of Contrast Induced Nephropathy

Significance of Canada Acute Coronary Syndrome Risk Score in Emergency Percutaneous Revascularization for the Prediction of Contrast Induced Nephropathy

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

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