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Risk score assesses contrast-induced nephropathy after PCI
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An easily applied risk score for contrast-induced nephropathy after PCI allowed practical, simple assessments compared with other published scores, according to recent study findings.
To develop a simple risk score for developing contrast-induced nephropathy (CIN) after PCI (defined as an increase ≥25% and/or ≥0.5 mg/dL in serum creatinine at 48 hours after PCI vs. baseline), researchers enrolled consecutive patients treated with elective or urgent PCI at a cardiac cath lab (derivation cohort, n=488; validation cohort, n=200) from September 2008 to January 2010.
CIN occurred in 10.2% (50 of 488) of the development cohort with a significant trend across increasing score values (P<.001).
The risk score model uses the addition of five key variables, four clinical and one procedural, to predict the risk for CIN after PCI: pre-existing renal disease; metformin use; previous PCI; peripheral arterial disease; and contrast volume ≥300 mL.
Researchers said the model had a discriminating power c-statistic of 0.759 and a calibration slope of 0.91. Internal validation bootstrapping in 1,000 samples offered a c-statistic of 0.753, and the validation cohort of 200 patients offered a c-statistic of 0.864.
“Using as a cut-off point a risk score value >3, our model correctly classified 83% of individuals with positive test (risk score of 4) as developing CIN, whereas 92% of individuals with negative test (risk scores of 0, 1, 2 and 3) were correctly classified as developing CIN,” the researchers wrote. “Therefore, the proposed risk score model with a diagnostic cut-off point of >3 offers both high negative and positive predicted value and provides the clinician a practical tool to safely rule-out or predict acute kidney injury after a PCI.”
Disclosure: The researchers report no relevant financial disclosures.
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