Mehran risk score model for predicting contrast-induced nephropathy after cardiac resynchronization therapy in patients with heart failure

Abstract

Aims: Contrast-induced nephropathy (CIN) is a challenging condition after cardiac procedures. Mehran risk score (MS) is a simple tool for predicting CIN. We investigated the role of MS to predict CIN development following cardiac resynchronization therapy (CRT) implantation in heart failure (HF) patients. Methods: This single-center, retrospective study included HF patients who underwent CRT implantation. The patients had New York Heart Association class II-IV disease, wide QRS in electrocardiogram (>130 ms), and diminished left ventricular ejection fraction (<35%). Patients with active bleeding, acute renal failure before the CRT procedure, liver cirrhosis, autoimmune disease, chronic or acute inflammatory diseases, end-stage malignancy, and receiving dialysis were excluded. Mehran CIN risk score was calculated using the patient records. Results: The study included 144 patients (age, mean±standard deviation: 63±10, male sex: 75%). Patients who developed CIN had significantly higher MS than those who did not (10.4±3.3 vs. 7.6±2.7, p<0.001). Multivariate logistic regression analyses showed that contrast volume [Odds ratio (OR): 1.02, 95% confidence interval (CI): 1.00-1.04, p=0.029] and MS (OR: 1.34 95% CI: 1.10-1.63, p=0.004, respectively) were independently associated with development of CIN. Conclusions: This study showed that higher MS was independently associated with CIN in HF patients who underwent CRT implantation