Role of the CHA2DS2-Vasc Score in Predicting Contrast-Induced Nephropathy After Primary Percutaneous Coronary Intervention

Rantung, Nolly Octavianes Habel and Rampengan, Starry Homenta and Jim, Edmond Leonard and Ananda, Dewa Gde Prema and Langi, Fima Lanra Fredrik Gerarld (2024) Role of the CHA2DS2-Vasc Score in Predicting Contrast-Induced Nephropathy After Primary Percutaneous Coronary Intervention. The International Journal of Cardiovascular Sciences (Int J Cardiovasc Sci.). pp. 1-8. ISSN 23595647

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Abstract

Background: Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy for STelevation 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. Keywords: Contrast Media; Percutaneous Coronary Intervention; Infarto do Miocárdio com Supradesnível do Segmento ST.

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