Risk prediction of contrast-induced nephropathy by ACEF score in patients undergoing coronary catheterization

J Cardiovasc Med (Hagerstown). 2016 Jul;17(7):524-9. doi: 10.2459/JCM.0000000000000215.

Abstract

Aims: To explore the ability of the ACEF score to predict the incidence of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography with or without percutaneous coronary intervention.

Methods: A total of 706 patients undergoing coronary angiography ± percutaneous coronary intervention (PCI) between March 2011 and October 2011 were analyzed. CIN using different definitions was termed as CINnarrow (rise in serum creatinine ≥0.5 mg/dl) and CINbroad (rise in serum creatinine ≥0.5 mg/dl and/or ≥25% increase in baseline serum creatinine).

Results: The mean ACEF score was 1.5 ± 0.6. Overall incidences of CINnarrow and CINbroad were 5.5% and 13.6%, respectively. There was a significant gradient in the incidence of CINnarrow (2.9%, 3.9%, 10.6% in the I, II, and III tertiles, respectively, P < 0.001) and CINbroad (9.1%, 14.2%, 17.9% in the I, II, and III tertiles, respectively, P = 0.021) across increasing ACEF tertiles. The ACEF score was independently associated with the risk of CINnarrow (adjusted odds ratio [OR] 1.6, 95% confidence interval [CI] 1.0-2.7; P = 0.047). Discrimination was more satisfactory when using the ACEF as a predictor of CINnarrow (c-statistic 0.71, 95% 0.63-0.79).

Conclusion: The ACEF score is an independent and potentially useful predictor of CIN defined as rise in serum creatinine ≥0.5 mg/dl.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiac Catheterization / adverse effects*
  • Contrast Media / adverse effects*
  • Coronary Angiography / adverse effects*
  • Creatinine / blood
  • Female
  • Humans
  • Incidence
  • Italy
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / epidemiology*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Percutaneous Coronary Intervention
  • Predictive Value of Tests
  • ROC Curve
  • Risk Factors
  • Severity of Illness Index

Substances

  • Contrast Media
  • Creatinine