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Clin Cardiol. 2014 Aug;37(8):485-92. doi: 10.1002/clc.22291. Epub 2014 May 7.

Association between N-terminal pro-brain natriuretic peptide levels and contrast-induced nephropathy in patients undergoing percutaneous coronary intervention for acute coronary syndrome.

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1
Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.

Abstract

BACKGROUND:

Contrast-induced nephropathy (CIN) is associated with significantly increased morbidity and mortality after percutaneous coronary intervention (PCI). Patients with acute coronary syndrome (ACS) are at higher risk for CIN. N-terminal pro-brain natriuretic peptide (NT-proBNP) is closely linked to the prognosis as a strong predictor of both short- and long-term mortality in patients with ACS.

HYPOTHESIS:

We hypothesized that NT-proBNP levels on admission can predict the development of CIN after PCI for ACS.

METHODS:

A total of 436 patients (age 62.27 ± 13.01 years; 64.2% male) with ACS undergoing PCI enrolled in this study. Admission NT-proBNP levels were measured before PCI. Serum creatinine values were measured before and within 72 hours after the administration of contrast agents. Patients were divided into 2 groups: CIN group and no-CIN group. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dL or ≥25% above baseline within 72 hours after contrast administration.

RESULTS:

CIN developed in 63 patients (14.4%). Baseline NT-proBNP levels were significantly higher in patients who developed CIN compared to those who did not develop CIN (median 774 pg/mL, interquartile range 177.4-2184 vs median 5159 pg/mL, interquartile range 2282-9677, respectively; P < 0.001). Multivariate analysis found that NT-proBNP (odds ratio [OR]: 3.448, 95% confidence interval [CI]: 1.394-8.474, P = 0.007) and baseline creatinine (OR: 6.052, 95% CI: 1.860-19.686, P = 0.003) were independent predictors of CIN.

CONCLUSIONS:

Admission NT-proBNP level is an independent predictor of the development of CIN after PCI in ACS.

PMID:
24805995
DOI:
10.1002/clc.22291
[Indexed for MEDLINE]
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