Nolly Octavianes Habel Rantung et al. Starry Homenta Rampengan Edmond Leonard Jim Dewa Gde Prema Ananda Fima Lanra Fredrik Gerarld Langi
Abstract
Background
Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy for ST-elevation myocardial infarction (STEMI) with an onset time <12 h. However, it poses a risk of contrast-induced nephropathy (CIN), occurring in one out of five patients. In this context, the CHA2DS2-VASc score can be used as a predictor of CIN in patients with STEMI undergoing PPCI.
Objectives
To evaluate the role of the CHA2DS2-VASc score in predicting CIN in patients with STEMI who underwent PPCI.
Methods
In this retrospective cohort study, data were collected from the medical records of patients with STEMI who underwent PPCI at the department of cardiovascular medicine of our institution from January 1, 2019, to October 31, 2021. The association of CIN with the CHA2DS2-VASc and Mehran scores, the and neutrophil–lymphocyte ratio were evaluated using a logistic regression model with a p value < 0.05.
Results
This study included 66 patients with CIN from a total of 326 patients with STEMI who underwent PPCI. Patients with CIN showed a higher CHA2DS2-VASc score compared with those without CIN (median [interquartile range — IQR], 2 [1–3] vs. 1 [1–2], p < 0.001). The sensitivity, specificity, negative predictive value, and positive predictive value of the CHA2DS2-VASc score in predicting CIN after PPCI were 73.6%, 92.3%, 87.9%, and 82.1%, respectively.
Conclusion
A CHA2DS2-VASc score ≥ 2.5 is as accurate as a Mehran score ≥6.5 in predicting CIN following PPCI, suggesting that the CHA2DS2-VASc score is a practical and efficient tool for clinical use.