Contrast Volume-to-Creatinine Clearance Ratio Predicts the Risk of Contrast-Induced Nephropathy After Percutaneous Coronary Intervention in Patients With Reduced Ejection Fraction

Angiology. 2015 Aug;66(7):625-30. doi: 10.1177/0003319714548442. Epub 2014 Aug 26.

Abstract

We determined a relatively safe contrast media volume-to-creatinine clearance (V/CrCl) cutoff value to avoid contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in patients (n = 111) with reduced ejection fraction (<40%). Improved prediction of CIN in these patients would be useful. Multivariate regression models were used to evaluate whether V/CrCl is an independent risk factor for CIN. Nine (8.1%) patients developed CIN. The V/CrCl was significantly (P = .023) higher in patients with CIN than in those without. The incidence of CIN in patients with the highest tertile of V/CrCl was significantly higher than the middle and lowest tertiles (18.4% vs. 2.7% and 2.8%; P = .013). After adjusting for other potential risk factors, a V/CrCl ≥3.87 remained significantly associated with risk of CIN. A V/CrCl <3.87 might be valuable in predicting the risk of CIN in patients with reduced ejection fraction undergoing PCI.

Keywords: contrast volume; contrast-induced nephropathy; creatinine clearance; percutaneous coronary intervention; predict; reduced ejection fraction.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / blood
  • Contrast Media / adverse effects*
  • Contrast Media / pharmacokinetics
  • Creatinine / blood*
  • Female
  • Humans
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / prevention & control*
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention*
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Factors
  • Stroke Volume

Substances

  • Biomarkers
  • Contrast Media
  • Creatinine