Assessing contrast-induced nephropathy risk in older adults undergoing coronary angiography and intervention: The CV/GFR ratio versus Mehran score.

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL SAGE Open Medicine Pub Date : 2024-10-09 eCollection Date: 2024-01-01 DOI:10.1177/20503121241275419
Tan Van Nguyen, Nhi Tuyet Quang, Weber Liu, Ngo Thi Kim Trinh, Tu Ngoc Nguyen
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Abstract

Background: Contrast-induced nephropathy is a prevalent cause of hospital-acquired renal insufficiency and increases adverse events in older patients undergoing angiography and percutaneous coronary intervention. The Mehran risk score has been widely used in Vietnam to assess contrast-induced nephropathy risk in patients before coronary angiography and percutaneous coronary intervention. Recently, there has been a shift toward the adoption of simpler risk prediction models, such as the contrast volume-to-glomerular filtration rate ratio. This study aimed to (1) determine the incidence of contrast-induced nephropathy in older patients undergoing coronary angiography and/or percutaneous coronary intervention, and (2) compare the validity of the contrast volume-to-glomerular filtration rate ratio and the Mehran score in predicting contrast-induced nephropathy.

Method: This is a prospective cohort study conducted at a hospital in Vietnam from September 2019 to May 2020. Consecutive patients aged ⩾60 years who underwent coronary angiography and/or percutaneous coronary intervention were recruited. The contrast volume-to-glomerular filtration rate ratio and the Mehran score were evaluated for their predictive utility regarding contrast-induced nephropathy risk. The receiver operator characteristic was employed to calculate the area under the curve for both the contrast volume-to-glomerular filtration rate ratio and the Mehran score in predicting contrast-induced nephropathy.

Results: The study included 170 participants with a mean age of 70 years and 33.1% were female. Contrast-induced nephropathy was diagnosed in 9.4% of the participants. Participants with contrast-induced nephropathy exhibited a higher prevalence of chronic kidney disease, anemia, and heart failure. There was no significant difference between the area under the curves of the contrast volume-to-glomerular filtration rate ratio (0.79, 95% CI: 0.65-0.92), and the Mehran score (0.65, 95% CI: 0.51-0.82) in predicting contrast-induced nephropathy.

Conclusion: Our findings indicate that contrast-induced nephropathy was prevalent among older patients following percutaneous coronary intervention. The contrast volume-to-glomerular filtration rate ratio demonstrated a good prognostic value for predicting contrast-induced nephropathy comparable to that of the Mehran score. Further research is needed to identify optimal cutoff values for the contrast volume-to-glomerular filtration rate ratio in older patients.

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评估接受冠状动脉造影术和介入治疗的老年人造影剂诱发肾病的风险:CV/GFR比值与Mehran评分的比较。
背景:造影剂诱发的肾病是医院获得性肾功能不全的常见原因,并增加了接受血管造影术和经皮冠状动脉介入治疗的老年患者的不良事件。在越南,Mehran 风险评分已被广泛用于评估冠状动脉造影术和经皮冠状动脉介入治疗前患者的造影剂诱发肾病风险。最近,人们开始转向采用更简单的风险预测模型,如造影剂容量与肾小球滤过率的比值。本研究旨在:(1)确定接受冠状动脉造影术和/或经皮冠状动脉介入治疗的老年患者造影剂诱发肾病的发生率;(2)比较造影剂容量-肾小球滤过率比值和 Mehran 评分在预测造影剂诱发肾病方面的有效性:这是一项前瞻性队列研究,于 2019 年 9 月至 2020 年 5 月在越南一家医院进行。研究对象为接受冠状动脉造影术和/或经皮冠状动脉介入治疗的 60 岁以上连续患者。评估了造影剂容量-肾小球滤过率比值和 Mehran 评分对造影剂诱发肾病风险的预测作用。采用受体运算特征来计算造影剂容量-肾小球滤过率比值和 Mehran 评分在预测造影剂诱发肾病方面的曲线下面积:该研究包括 170 名参与者,平均年龄为 70 岁,33.1% 为女性。9.4%的参与者被确诊为造影剂诱发肾病。患有造影剂诱发肾病的参与者患有慢性肾病、贫血和心力衰竭的比例较高。在预测造影剂诱发肾病方面,造影剂容量与肾小球滤过率之比的曲线下面积(0.79,95% CI:0.65-0.92)与 Mehran 评分(0.65,95% CI:0.51-0.82)之间没有明显差异:我们的研究结果表明,造影剂诱发肾病在经皮冠状动脉介入治疗后的老年患者中很普遍。造影剂容量-肾小球滤过率比值在预测造影剂诱发肾病方面具有良好的预后价值,与 Mehran 评分相当。还需要进一步研究,以确定老年患者造影剂容量-肾小球滤过率比值的最佳临界值。
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来源期刊
SAGE Open Medicine
SAGE Open Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
4.30%
发文量
289
审稿时长
12 weeks
期刊最新文献
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