GRACE risk score predicts contrast-induced nephropathy in patients with acute coronary syndrome and normal renal function

Angiology. 2013 Jan;64(1):31-9. doi: 10.1177/0003319711434800. Epub 2012 Feb 1.

Abstract

We evaluated the incidence, clinical predictors, and outcomes of contrast-induced nephropathy (CIN) after coronary angiography in patients with myocardial infarction and normal kidney function. We studied 202 consecutive patients with glomerular filtration rate >60 mL/min/1.73 m(2). The CIN was defined according to 3 definitions: increases in serum creatinine (sCr) ≥25%, ≥0.3 mg/dL, and ≥0.5 mg/dL. The CIN occurred in 56 (27.7%), 42 (20.8%), and 13 (6.4%) patients, respectively. In multivariate analysis, the presence of a high Global Registry of Acute Coronary Events (GRACE) risk score (>140) was an independent predictor of CIN in its milder forms (≥25% and ≥0.3 mg/dL of rise in sCr). Increase in sCr ≥0.3 mg/dL was an independent predictor of bleeding. Increase in sCr ≥0.5 mg/dL was an independent predictor of in-hospital cardiac events (mortality, myocardial infraction [MI], and heart failure). As conclusion, the GRACE score is a useful tool to predict CIN in patients with MI and normal renal function.

MeSH terms

  • Acute Coronary Syndrome / diagnostic imaging*
  • Acute Coronary Syndrome / mortality
  • Acute Coronary Syndrome / physiopathology
  • Contrast Media / adverse effects*
  • Coronary Angiography / adverse effects*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Incidence
  • Kidney / diagnostic imaging
  • Kidney / physiopathology*
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / diagnostic imaging
  • Kidney Diseases / physiopathology
  • Male
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / mortality
  • Myocardial Infarction / physiopathology*
  • Risk Assessment
  • Risk Factors

Substances

  • Contrast Media