Role of Elevated Arterial Lactate as a Predictor for Contrast Induced Nephropathy Following Percutaneous Coronary Intervention in Diabetic Patients with ACS

Abstract Background Estimated incidence of contrast induced nephropathy (CIN) from variable prospective studies varied widely and ranged from 0% and up to 24%. This is mainly due to the variation in comorbidities, basal creatinine level and other causes of acute kidney injury. The mechanism of CIN is multifactorial. It has been demonstrated that contrast media decreases the antioxidant activity in the nephron and cause direct cytotoxicity to the renal cells, as well. Objective To assess the role of elevated arterial lactate as a predictor for contrast induced nephropathy following percutaneous coronary intervention in Diabetic patients with acute coronary syndrome. Methods This prospective descriptive study was done on 200 diabetic patients with acute coronary syndrome underwent percutaneous coronary intervention in Ain Shams University during the study period (6 months) from 9/2023 to 2/2024. Results We found that higher pre procedure arterial lactate level was associated with an increased risk of CIN in diabetic patients with ACS after PCI. We found by multivariate analysis that the most statistically significant predictors for occurrence of CIN in the studied group were presence of arterial lactate > 1 and whole procedure time >69 min Conclusion Pre procedure arterial lactate is a strong independent predictor of contrast-induced nephropathy in diabetic patient with acute coronary syndrome underwent PCI.