Canada Acute Coronary Syndrome Score: A Preprocedural Risk Score for Contrast-Induced Nephropathy After Primary Percutaneous Coronary Intervention

Angiology. 2017 Oct;68(9):782-789. doi: 10.1177/0003319717690674. Epub 2017 Jan 31.

Abstract

In patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention, contrast-induced nephropathy (CIN) is a serious complication associated with poor outcomes. We assessed the predictive value of the Canada Acute Coronary Syndrome (C-ACS) score for CIN in these patients. A total of 394 consecutive patients with STEMI were enrolled and divided into 3 groups according to their C-ACS scores-group 1, score 0; group 2, score 1; and group 3, score ≥2. The clinical outcomes were CIN and major adverse clinical events (MACEs) during hospital and follow-up; 8.4% of patients developed CIN. Patients with high C-ACS scores were more likely to develop CIN, in-hospital death, and MACEs ( P < .001). The C-ACS score was an independent predictor of CIN (odds ratio = 2.87; 95% confidence interval = 1.78-4.63; P < .001) and risk factor for long-term MACEs. The C-ACS score had good predictive values for CIN, in-hospital morality, MACEs, and long-term mortality. Patients with high C-ACS risk scores exhibited a worse survival rate than those with low scores (death, P = .02; MACEs, P = .006). In conclusion, in patients with STEMI, the C-ACS could predict CIN and clinical outcomes.

Keywords: Canada Acute Coronary Syndrome score; ST-segment elevation myocardial infarction; contrast-induced nephropathy; percutaneous coronary intervention.

MeSH terms

  • Acute Coronary Syndrome / mortality*
  • Acute Coronary Syndrome / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Canada
  • Contrast Media / adverse effects*
  • Coronary Angiography / adverse effects
  • Female
  • Humans
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / mortality
  • Male
  • Middle Aged
  • Myocardial Infarction / chemically induced
  • Myocardial Infarction / mortality*
  • Percutaneous Coronary Intervention / adverse effects*
  • Percutaneous Coronary Intervention / mortality
  • Risk Assessment
  • Risk Factors
  • Time Factors

Substances

  • Contrast Media