Contrast‐induced nephropathy is associated with new‐onset atrial fibrillation in acute coronary syndrome after cardiac catheterization: Systemic review and meta‐analysis

Abstract

Introduction Contrast‐induced nephropathy (CIN) is associated with increased cardiovascular morbidity and mortality in patients with acute coronary syndrome (ACS). Recent studies suggest that CIN is associated with new‐onset atrial fibrillation (AF) in patients with acute coronary syndrome (ACS) who underwent catheterization. However, a systematic review and meta‐analysis of the literature have not been done. We assessed the association between CIN in patients with ACS and new‐onset AF by a systematic review of the literature and a meta‐analysis. Hypothesis CIN is associated with new‐onset AF in patients with ACS. Methods We comprehensively searched the databases of MEDLINE and EMBASE from inception to April 2018. Included studies were published cohort studies that compared new‐onset AF after cardiac catheterization in ACS patient with CIN versus without CIN. Data from each study were combined using the random effects, generic inverse variance method of DerSimonian and Laird to calculate risk ratios and 95% confidence intervals. Results Five studies from December 2009 to February 2018 were included in this meta‐analysis involving 5,640 subjects with ACS (1,102 with CIN and 4,538 without CIN). Contrast‐induced nephropathy significantly correlates with new‐onset AF after cardiac catheterization (pooled risk ratio = 2.84, 95% confidence interval: 1.66–4.87, p < 0.001, I2 = 58%) Conclusions Contrast‐induced nephropathy is associated with new‐onset AF threefold among patients with ACS after cardiac catheterization. Our study warranted further study to establish the causality between CIN and new‐onset AF.

Assessment of Predictive Value of SYNTAX-II Score for Adverse Cardiac Events and Clinical Outcomes in Patients With Acute Coronary Syndrome

“…The incidence of CIN (23.5%) in our study was higher than in previous reports. 36,37 This may be the result of older age of the study population, increased prevalence of DM and HT, increased amount of use of contrast media and delayed initiation of hydration therapy due to the clinical presentation of the patients. In the present study, value of SSII-PCI score in CIN prediction was considerably high; values >32.55 were associated with 17fold increased risk of developing CIN.…”