SYNTAX score of infarct-related artery other than the number of coronary balloon inflations and deflations as an independent predictor of contrast-induced acute kidney injury in patients with ST-segment elevation myocardial infarction

Cheng Wei Liu, Pen Chih Liao, Kuo Chin Chen, Jung Cheng Hsu, Chung Ming Tu, Yen Wen Wu, Ai Hsien Li, Shin Rong Ke, Jiunn-Lee Lin

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Abstract

Background: Although remote ischemic post-conditioning (RIPC) has been shown to prevent contrast-induced acute kidney injury (CIAKI) in patients with acute coronary syndrome, its efficacy in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. We examined the relationship among balloon inflations and deflations (BID) times, SYNTAX score of infarction-related artery (SI), periprocedural complications, and CIAKI in STEMI patients undergoing primary percutaneous coronary intervention (pPCI). Methods: Patients with STEMI undergoing pPCI with Mehran risk score (MRS) ≥ 5 were enrolled between February 2007 and September 2012. The study end point was the development of CIAKI. Results: Of 206 patients, the median age was 65 years [interquartile range (IQR): 55-77] with 72.8% male and Mehran risk score (MRS) 8 (IQR: 6-12). Receiver operating characteristic curve showed that BID times > 9 times or SI > 10was the best cut-off associated with CIAKI. In univariate analysis, significant associationwith CIAKI existed in BID > 9 times [odds ratio (OR): 3.106, 95% confidence interval (CI): 1.284-7.513, p = 0.012] and SI > 10 (OR: 3.909, 95% CI: 1.570-9.735, p = 0.003). Other variables associated with CIAKI included creatinine, hemoglobin, angiotensin converting enzyme inhibitor or angiotensin receptor blocker use at discharge. In multivariate analysis, SI > 10 remained an independent predictor of CIAKI in different adjustment model, even on top of MRS (adjusted OR: 3.498, 95% CI: 1.086-11.268, p = 0.036). Conclusions: Vascular complexity of infarct-related artery rather than higher BID times (> 9) was the major determinant of the development of CIAKI after pPCI in STEMI patients.

Original languageEnglish
Pages (from-to)362-376
Number of pages15
JournalActa Cardiologica Sinica
Volume33
Issue number4
DOIs
Publication statusPublished - Jul 1 2017
Externally publishedYes

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Keywords

  • Acute kidney injury
  • Acute myocardial infarction
  • Primary percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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