Predictive value of combining the level of fibrinogen and CHA2DS2-VASC Score for contrast-induced acute kidney injury in patients with acute coronary syndromes undergoing percutaneous coronary intervention.

Abstract

OBJECTIVE:

The present study aimed to investigate the value of preprocedural fibrinogen (FIB) combined with CHA2DS2-VASC scores in the risk prediction of contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI) in patients with acute coronary syndromes (ACS).

METHOD:

A total of 934 patients (mean age 63.9 ± 11.5 years, and 32.1% female), who were admitted to our hospital for ACS and underwent PCI, were retrospectively enrolled. The patients were divided into two groups: non-CI-AKI group (n = 787) and CI-AKI group (n = 147). Contrast-induced acute kidney injury was defined as an increase of ≥ 0.5 mg/dL or ≥ 25% serum creatinine within 48-72 h after PCI. Spearman correlation analysis was used to determine the relationship between FIB and CHA2DS2-VASC scores.

RESULTS:

Patients with high baseline FIB levels and high CHA2DS2-VASC scores had higher CI-AKI incidence. On spearman correlation analysis, FIB and CHA2DS2-VASC scores were positively correlated (R = 0.236, P < 0.001). The ROC statistical analysis showed that the combination had 63.3% sensitivity with 72.6% specificity for the development of CI-AKI (area under the curve: 0.727, 95% CI 0.697-0.755, P < 0.001). A total of 934 ACS patients were divided into low-risk group (404 cases), medium-risk group (383 cases) and high-risk group (147 cases) according to the cut-off values of FIB and CHA2DS2-VASC scores. The incidence of CI-AKI was higher in the high-risk group than in the low-risk and medium-risk groups (Log-rank χ2 = 104.505, 56.647. P < 0.001). Multivariate analysis revealed that albumin (OR = 0.913, 95% CI 0.867-0.962), FIB (OR = 1.451, 95% CI 1.185-1.77), CHA2DS2-VASC score (OR = 1.271, 95% CI 1.504-1.78) were the independent risk factors of CI-AKI (p < 0.05).

CONCLUSION:

The preprocedural fibrinogen combined with CHA2DS2-VASC score is independently associated with the risk of CI-AKI in ACS patients treated by PCI.

• Authors: Jing Li, Zhen Wang, BaiXiang Zhang, Di Zheng, Yuan Lu, Wenhua Li
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 54 Issue 9 Pg. 2385-2392 (Sep 2022) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 35182313 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer Nature B.V.

Chemical References

• Contrast Media
• Fibrinogen

Topics

• Acute Coronary Syndrome (surgery)
• Acute Kidney Injury (etiology)
• Aged
• Contrast Media (adverse effects)
• Female
• Fibrinogen
• Humans
• Male
• Middle Aged
• Percutaneous Coronary Intervention (adverse effects)
• Predictive Value of Tests
• Retrospective Studies
• Risk Assessment
• Risk Factors