Hubungan Antara Skor CHA2DS2-VASC dengan Kejadian Nefropati yang Diinduksi Kontras pada Pasien Infark Miokard Akut yang Menjalani Prosedur Intervensi Koroner Perkutan

Abstract

Background: Contrast Induced Nephropathy (CIN) is a serious issue after Percutaneous Coronary Intervention (PCI) for Acute Myocardial Infarction (AMI) patients. The development of CIN is associated with increased in-hospital and long-term morbidity and mortality despite succesful early coronary revascularization. The CHA2DS2-VASC score has been reported recently to predict adverse clinical outcomes so is CIN in patients with AMI regardless of having atrial fibrillation. We investigated relationship between CHA2DS2-VASC score with CIN in patients with AMI who underwent PCI strategies. Method: This is an ambispective cohort study of 40 patients with AMI who were admited at cardiac care unit in our centre and underwent PCI. The CHA2DS2-VASC score was calculated for each patient. From this study 16 cases (40%) with overall prevalence 18.82% of CIN were diagnosed. CIN was defined as a rise in serum creatinine >0,5 mg/dL or >25% increase in baseline within 24 hours after PCI. Results: In the ROC curve analysis, the cut-off value of CHA2DS2-VASC score in the prediction of CIN was > 3 with a sensitivity of 56.25% and specificity of 87.5% (AUC 0.698, 95%:CI 1.460- 6.163, p=0.003) and has a significant association with CIN (R2 0.485). From multivariate analysis, we also identified Hb level < 12 mg/dL as an independent predictor of CIN with (RR 3.44, 95%:CI 1.816-6.532, p<0.001). Conclusion: The CHA2DS2-VASC score was positively associated with CIN. Therefore, it can be used as a simple and reliable tools to predict CIN in AMI patients who underwent PCI.