Value of CHA2DS2-VASc score and safe contrast volume for early detection of contrast induced nephropathy after percutaneous coronary intervention

Abstract Background The CHA2DS2-VASc score is utilized to order the danger of embolization in atrial fibrillation (AF). Also it has been assessed to expect the worse clinical scenario in acute coronary syndrome patients, regardless of having AF. Therefore, the study aim was to use CHA2DS2-VASc score that has such a large area of use and the safe contrast volume – that represented by volume of the dye to creatinine clearance ratio (V/CrCl) – for contrast induced nephropathy (CIN) early detection after PCI. Patients and methods A total of 259 patients who underwent elective or primary PCI were enrolled in the study. For each patient, The CHA2DS2-VASc score and V/CrCl was evaluated. The patients in our study were divided, according to CIN development to two groups. CIN was identified as a rise in serum creatinine >0.5 mg/dl or >25% increase in baseline within48 to 72 hours after PCI. Statistical analysis: the receiver operating characteristic analysis was used to detect the best cut off values to predict CIN, and we concluded the independent predictors of CIN through multivariate logistic regression analysis. Results There was significant positive correlation between Mehran score and CHA2DS2-VASc score. Independent predictors of CIN were Mehran score, V/CrCl ratio>3.2 and CHA2DS2-VASc >3, CHF or EF <40%, hypotension, anemia, primary PCI and weight. If the patient had (CHA2DS2-VASc score>3 or V/CrCl >3.2), as a single predictor, we can predict CIN with (sensitivity 96.97%, 95% CI 0.71 to 0.82). Conclusion The Mehran score, V/CrCl ratio and CHA2DS2-VASc score are strong predictors of CIN, and we can use CHA2DS2-VASc score and safe contrast volume for early detection of CIN after PCI. Funding Acknowledgement Type of funding sources: None.