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Scholarly Commons > HCA Healthcare Journal > Vol. 1 > Iss. 5 (2020)

 

Keywords

cardiac catheterization; contrast media/averse effects; acute kidney injury; coronary artery disease; myocardial infarction; percutaneous coronary intervention

Disciplines

Cardiology | Nephrology

Abstract

Background: A comparison of acute kindney injury (AKI) post-percutaneous coronary intervention (PCI) prediction models is lacking. In this study, we aim to compare the National Cardiovascular Data Registry (NCDR) CathPCI score to the Mehran score in acute coronary syndrome (ACS) vs non-ACS patients.

Methods: We included patients who received PCI at our facility between July 2015 and December 2017. We excluded patients without a pre- and/or post-PCI serum creatinine, patients on dialysis at the time of PCI and patients with missing variables required to calculate the predictive scoring model. The primary outcome of this study was AKI post-PCI. Performance of the NCDR CathPCI score and the Mehran score were evaluated by comparing the area under the receiver-operating characteristic curve (AUROC) for both scores.

Results: The analysis included 1,507 patients. In non-ACS patients, the Mehran score performed better than the NCDR CathPCI score with AUROC 0.75 and 0.68 respectively (p=0.014). When categorized into 4 risk groups, a Mehran score ≥ 2 had a sensitivity of 86% and a Mehran score of ≥ 3 had a specificity of 83% in non-ACS patients. In contrast, when the NCDR CathPCI score was categorized into risk groups, it was not able to predict the risk of AKI (p=0.78) with sensitivity of 0% for the intermediate and high risk group. In ACS patients, the NCDR CathPCI score was superior in predicting the risk for AKI with AUROC 0.79 versus 0.74 (p=.019).

Conclusion: In predicting AKI post-PCI, the NCDR CathPCI score performed better in ACS populations, and the Mehran score performed better in the non-ACS population.

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