GRACE Risk Score Predicts Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome and Normal Renal Function

Abstract

We evaluated the incidence, clinical predictors, and outcomes of contrast-induced nephropathy (CIN) after coronary angiography in patients with myocardial infarction and normal kidney function. We studied 202 consecutive patients with glomerular filtration rate >60 mL/min/1.73 m(2). The CIN was defined according to 3 definitions: increases in serum creatinine (sCr) ≥25%, ≥0.3 mg/dL, and ≥0.5 mg/dL. The CIN occurred in 56 (27.7%), 42 (20.8%), and 13 (6.4%) patients, respectively. In multivariate analysis, the presence of a high Global Registry of Acute Coronary Events (GRACE) risk score (>140) was an independent predictor of CIN in its milder forms (≥25% and ≥0.3 mg/dL of rise in sCr). Increase in sCr ≥0.3 mg/dL was an independent predictor of bleeding. Increase in sCr ≥0.5 mg/dL was an independent predictor of in-hospital cardiac events (mortality, myocardial infraction [MI], and heart failure). As conclusion, the GRACE score is a useful tool to predict CIN in patients with MI and normal renal function.

Comparative Study of Predictive Value for Different Risk Scores for Predicting Contrast Induced Nephropathy and Short Outcome after Primary Percutaneous Coronary Intervention

“…Depressed EF <45% (p value=0.151), which was concordant with Raposeiras-Roubín et al, [12] who demonstrated that depressed EF was not a predictor of CIN (p value=0.541).…”

“…However, Raposeiras-Roubin et al, [12] studied 202 consecutive patients presented with acute myocardial infarction (STEMI and NSTEMI) and with normal kidney function (eGFR>60/mL/min/ 1.7 m 2 ) undergoing coronary angiography and follow up during hospital stay. The incidence of CIN was 6% which was lower than our study, as we did not exclude patients presented with renal dysfunction from the study as 20% of our study population presented with renal dysfunction (eGFR<60 ml/min/1.73 m 2 ).…”

“…Our data may due to the fact that we had only 11% of our study population with age of seventy or older. However, RaposeirasRoubín et al, [12] found that Age ≥ 75 years was not a significant risk factor for CIN (p value= 0.365).…”

“…Ando et al, demonstrated that the ACEF risk score which include Age, serum crat is useful to predict CIN in patients with STEMI, while also demonstrating that the modified ACEF (AGEF) score has a similar discriminative ability for CIN [10,11]. In addition, Raposeiras-Roubin et al, [12] reported that the GRACE score is useful for predicting CIN in patients n a cohort of Chinese patients undergoinwith acute coronary syndrome with normal renal function [13]. The Gao and Chen risk scores were established based og PCI, without discrimination based on the underlying condition.…”

Serum Neutrophil Gelatinase-Associated Lipocalin and Cystatin C are early Biomarkers of Contrast-Induced Nephropathy After Coronary Angiography in Patients With Chronic Kidney Disease

“…The Global Registry of Acute Coronary Events (GRACE) score was developed by Raposeiras-Roubín et al for use in patients with acute coronary syndrome and normal renal function. 15 Patients with a GRACE score >140 are at increased risk of developing CIN. 15 Fu et al established a risk score named CR4EATME3AD3 to assess the risk of CIN in elderly patients undergoing percutaneous coronary intervention (PCI).…”