CHADS2 score predicts risk of contrast-induced nephropathy in stable coronary artery disease patients undergoing percutaneous coronary interventions

Ruey-Hsing Chou; Po-Hsun Huang; Chien-Yi Hsu; Hsin-Bang Leu; Shao-Sung Huang; Chin-Chou Huang; Jaw-Wen Chen; Shing-Jong Lin

doi:10.1016/j.jfma.2015.12.008

CHADS2 score predicts risk of contrast-induced nephropathy in stable coronary artery disease patients undergoing percutaneous coronary interventions

Ruey-Hsing Chou, Po-Hsun Huang, Chien-Yi Hsu, Hsin-Bang Leu, Shao-Sung Huang, Chin-Chou Huang, Jaw-Wen Chen, Shing-Jong Lin

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

Abstract

BACKGROUND/PURPOSE: To investigate the correlation between the CHADS2 score and risk of contrast-induced nephropathy (CIN), we conducted a retrospective study in patients who underwent elective percutaneous coronary intervention (PCI) and compared its accuracy with previous scoring systems.

METHODS: A total of 539 patients who underwent elective PCI were enrolled. Based on their underlying diseases, such as hypertension, diabetes, and kidney disease, CHADS2 score, R2CHADS2 score, and Mehran's risk score were calculated for each patient. Incidence of CIN was defined as a rise in serum creatinine >0.5 mg/dL or >25% increase in baseline within 48 hours after PCI. All study participants were followed up until October 2014, or until the occurrence of major adverse cardiovascular events (MACEs).

RESULTS: Overall, 55 cases (10.2%) of CIN and 90 cases (16.7%) of MACEs were identified after participants were followed up for 1.57 ± 1.46 years. The study cohort was divided into three groups according to CHADS2 scores: score 0, score 1-2, and score 3-6. In multivariate analysis, an increase of 1 point in the CHADS2 score was independently associated with a 37% increase in the risk of CIN (odds ratio, 1.37; 95% confidence interval, 1.00-1.87; p = 0.048) and a 49% increase in MACEs (hazard ratio, 1.49; 95% confidence interval, 1.18-1.88, p = 0.001). In pairwise comparison, the discriminatory performance of CHADS2 score was not inferior to either R2CHADS2 score (p = 0.226) or Mehran's risk score (p = 0.075).

CONCLUSION: CHADS2 score could be a simple and useful predictor for CIN in patients undergoing elective PCI.

Original language	English
Pages (from-to)	501-9
Number of pages	9
Journal	Journal of the Formosan Medical Association = Taiwan yi zhi
Volume	115
Issue number	7
DOIs	https://doi.org/10.1016/j.jfma.2015.12.008
Publication status	Published - Jul 2016
Externally published	Yes

Keywords

Acute Kidney Injury/chemically induced
Aged
Aged, 80 and over
Contrast Media/adverse effects
Coronary Angiography/adverse effects
Coronary Artery Disease/surgery
Creatinine/blood
Female
Humans
Incidence
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Percutaneous Coronary Intervention
Predictive Value of Tests
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Taiwan

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Chou, R-H., Huang, P-H., Hsu, C-Y., Leu, H-B., Huang, S-S., Huang, C-C., Chen, J-W., & Lin, S-J. (2016). CHADS2 score predicts risk of contrast-induced nephropathy in stable coronary artery disease patients undergoing percutaneous coronary interventions. Journal of the Formosan Medical Association = Taiwan yi zhi, 115(7), 501-9. https://doi.org/10.1016/j.jfma.2015.12.008

CHADS2 score predicts risk of contrast-induced nephropathy in stable coronary artery disease patients undergoing percutaneous coronary interventions. / Chou, Ruey-Hsing; Huang, Po-Hsun; Hsu, Chien-Yi; Leu, Hsin-Bang; Huang, Shao-Sung; Huang, Chin-Chou; Chen, Jaw-Wen; Lin, Shing-Jong.

In: Journal of the Formosan Medical Association = Taiwan yi zhi, Vol. 115, No. 7, 07.2016, p. 501-9.

Research output: Contribution to journal › Article › peer-review

Chou, R-H, Huang, P-H, Hsu, C-Y, Leu, H-B, Huang, S-S, Huang, C-C, Chen, J-W & Lin, S-J 2016, 'CHADS2 score predicts risk of contrast-induced nephropathy in stable coronary artery disease patients undergoing percutaneous coronary interventions', Journal of the Formosan Medical Association = Taiwan yi zhi, vol. 115, no. 7, pp. 501-9. https://doi.org/10.1016/j.jfma.2015.12.008

Chou, Ruey-Hsing ; Huang, Po-Hsun ; Hsu, Chien-Yi ; Leu, Hsin-Bang ; Huang, Shao-Sung ; Huang, Chin-Chou ; Chen, Jaw-Wen ; Lin, Shing-Jong. / CHADS2 score predicts risk of contrast-induced nephropathy in stable coronary artery disease patients undergoing percutaneous coronary interventions. In: Journal of the Formosan Medical Association = Taiwan yi zhi. 2016 ; Vol. 115, No. 7. pp. 501-9.

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abstract = "BACKGROUND/PURPOSE: To investigate the correlation between the CHADS2 score and risk of contrast-induced nephropathy (CIN), we conducted a retrospective study in patients who underwent elective percutaneous coronary intervention (PCI) and compared its accuracy with previous scoring systems.METHODS: A total of 539 patients who underwent elective PCI were enrolled. Based on their underlying diseases, such as hypertension, diabetes, and kidney disease, CHADS2 score, R2CHADS2 score, and Mehran's risk score were calculated for each patient. Incidence of CIN was defined as a rise in serum creatinine >0.5 mg/dL or >25% increase in baseline within 48 hours after PCI. All study participants were followed up until October 2014, or until the occurrence of major adverse cardiovascular events (MACEs).RESULTS: Overall, 55 cases (10.2%) of CIN and 90 cases (16.7%) of MACEs were identified after participants were followed up for 1.57 ± 1.46 years. The study cohort was divided into three groups according to CHADS2 scores: score 0, score 1-2, and score 3-6. In multivariate analysis, an increase of 1 point in the CHADS2 score was independently associated with a 37% increase in the risk of CIN (odds ratio, 1.37; 95% confidence interval, 1.00-1.87; p = 0.048) and a 49% increase in MACEs (hazard ratio, 1.49; 95% confidence interval, 1.18-1.88, p = 0.001). In pairwise comparison, the discriminatory performance of CHADS2 score was not inferior to either R2CHADS2 score (p = 0.226) or Mehran's risk score (p = 0.075).CONCLUSION: CHADS2 score could be a simple and useful predictor for CIN in patients undergoing elective PCI.",

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author = "Ruey-Hsing Chou and Po-Hsun Huang and Chien-Yi Hsu and Hsin-Bang Leu and Shao-Sung Huang and Chin-Chou Huang and Jaw-Wen Chen and Shing-Jong Lin",

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doi = "10.1016/j.jfma.2015.12.008",

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T1 - CHADS2 score predicts risk of contrast-induced nephropathy in stable coronary artery disease patients undergoing percutaneous coronary interventions

AU - Chou, Ruey-Hsing

AU - Huang, Po-Hsun

AU - Hsu, Chien-Yi

AU - Leu, Hsin-Bang

AU - Huang, Shao-Sung

AU - Huang, Chin-Chou

AU - Chen, Jaw-Wen

AU - Lin, Shing-Jong

PY - 2016/7

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N2 - BACKGROUND/PURPOSE: To investigate the correlation between the CHADS2 score and risk of contrast-induced nephropathy (CIN), we conducted a retrospective study in patients who underwent elective percutaneous coronary intervention (PCI) and compared its accuracy with previous scoring systems.METHODS: A total of 539 patients who underwent elective PCI were enrolled. Based on their underlying diseases, such as hypertension, diabetes, and kidney disease, CHADS2 score, R2CHADS2 score, and Mehran's risk score were calculated for each patient. Incidence of CIN was defined as a rise in serum creatinine >0.5 mg/dL or >25% increase in baseline within 48 hours after PCI. All study participants were followed up until October 2014, or until the occurrence of major adverse cardiovascular events (MACEs).RESULTS: Overall, 55 cases (10.2%) of CIN and 90 cases (16.7%) of MACEs were identified after participants were followed up for 1.57 ± 1.46 years. The study cohort was divided into three groups according to CHADS2 scores: score 0, score 1-2, and score 3-6. In multivariate analysis, an increase of 1 point in the CHADS2 score was independently associated with a 37% increase in the risk of CIN (odds ratio, 1.37; 95% confidence interval, 1.00-1.87; p = 0.048) and a 49% increase in MACEs (hazard ratio, 1.49; 95% confidence interval, 1.18-1.88, p = 0.001). In pairwise comparison, the discriminatory performance of CHADS2 score was not inferior to either R2CHADS2 score (p = 0.226) or Mehran's risk score (p = 0.075).CONCLUSION: CHADS2 score could be a simple and useful predictor for CIN in patients undergoing elective PCI.

AB - BACKGROUND/PURPOSE: To investigate the correlation between the CHADS2 score and risk of contrast-induced nephropathy (CIN), we conducted a retrospective study in patients who underwent elective percutaneous coronary intervention (PCI) and compared its accuracy with previous scoring systems.METHODS: A total of 539 patients who underwent elective PCI were enrolled. Based on their underlying diseases, such as hypertension, diabetes, and kidney disease, CHADS2 score, R2CHADS2 score, and Mehran's risk score were calculated for each patient. Incidence of CIN was defined as a rise in serum creatinine >0.5 mg/dL or >25% increase in baseline within 48 hours after PCI. All study participants were followed up until October 2014, or until the occurrence of major adverse cardiovascular events (MACEs).RESULTS: Overall, 55 cases (10.2%) of CIN and 90 cases (16.7%) of MACEs were identified after participants were followed up for 1.57 ± 1.46 years. The study cohort was divided into three groups according to CHADS2 scores: score 0, score 1-2, and score 3-6. In multivariate analysis, an increase of 1 point in the CHADS2 score was independently associated with a 37% increase in the risk of CIN (odds ratio, 1.37; 95% confidence interval, 1.00-1.87; p = 0.048) and a 49% increase in MACEs (hazard ratio, 1.49; 95% confidence interval, 1.18-1.88, p = 0.001). In pairwise comparison, the discriminatory performance of CHADS2 score was not inferior to either R2CHADS2 score (p = 0.226) or Mehran's risk score (p = 0.075).CONCLUSION: CHADS2 score could be a simple and useful predictor for CIN in patients undergoing elective PCI.

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KW - Incidence

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KW - Multivariate Analysis

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KW - Percutaneous Coronary Intervention

KW - Predictive Value of Tests

KW - Retrospective Studies

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KW - Risk Factors

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JO - Journal of the Formosan Medical Association

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