Risk score of contrast-induced nephropathy in patients after percutaneous coronary intervention

Abstract

Background: Contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) is still an issue in modern revascularization era. Recent risk stratification model used creatinine as biomarker which has some limitations. Increased ≥ 10 % of Cystatin-C after PCI has proven to be one of the earliest and accurate CIN after PCI biomarkers. The study aims to develop risk score based on predictors of contrast-induced nephropathy in patients after PCI with Cystatin-C as biomarker. Methods: A prospective cohort study of 129 patients after PCI at Dr. Kariadi General Hospital Semarang. Predictor analysis was carried out using bivariate chi-square test and multivariate logistic regression. The independent predictors obtained were then used as risk score variables. The Hosmer and Lemeshow calibration test and AUC ROC analysis for discrimination test tested the quality of the risk score. Results: There were 3 independent predictors used as the risk score variables: Hypotension (score 1), anemia (score 1), creatinine baseline >1.5 mg/dl (score 1). Patients with total score ≥1 have higher risk to have CIN after PCI. The risk score had a good quality with the Hosmer and Lemeshow calibration test > 0.05 and relative modest discrimination ROC AUC 0.700 (95% IK 0.585-0.815; p=0.001). Conclusions: A risk score for risk stratification CIN after PCI has been created. The score has good calibration and modest discrimination in predicting the risk of CIN after PCI.