Predictive Value of the Modified Mehran Score for Contrast-Induced Nephropathy After Transcatheter Aortic Valve Implantation

Angiology. 2024 Mar;75(3):267-273. doi: 10.1177/00033197231151269. Epub 2023 Jan 10.

Abstract

Considering the increasing use of the transcatheter aortic valve implantation (TAVI) procedure, the relationship of contrast-induced nephropathy (CIN) with post-TAVI mortality has become important. The Mehran score was developed to detect the risk of CIN development after cardiac intervention. We aimed to compare the role of the modified Mehran score, which can be calculated pre-procedure, in predicting CIN development and compare it with the original Mehran score. We retrospectively collected data from TAVI procedures at our institution between December 2016 and June 2021; of 171 patients, 44 (25.7%) had CIN. We found no association between contrast media volume and CIN (387 ± 120 vs 418 ± 139 mL, P = .303). High and very high modified Mehran score and preoperative C-reactive protein (CRP) level were independent risk factors for CIN development after TAVI procedure. The area under curve (AUC) was .686 with 95% CI: .591-.780 and P < .001, and also, with a cut-off point of >7.5 points, there was 79.5% sensitivity and 63.0% specificity; otherwise, with a cut-off point of >9.5 points, there was 54.5% sensitivity and 71.7% specificity, for the modified Mehran score. The modified Mehran score comes into prominence compared with the original Mehran score since it can be calculated pre-procedure.

Keywords: Mehran score; contrast-induced nephropathy; modified; pre-procedure; transcatheter aortic valve implantation.

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / surgery
  • Contrast Media / adverse effects
  • Humans
  • Kidney Diseases* / chemically induced
  • Kidney Diseases* / diagnosis
  • Kidney Diseases* / surgery
  • Retrospective Studies
  • Risk Factors
  • Transcatheter Aortic Valve Replacement* / adverse effects
  • Transcatheter Aortic Valve Replacement* / methods

Substances

  • Contrast Media