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A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention

Development and initial validation

Roxana Mehran, MD^*,, Eve D. Aymong, MD, MSc, FACC^*, Eugenia Nikolsky, MD, PhD^*,, Zoran Lasic, MD, FACC^*, Ioannis Iakovou, MD^*, Martin Fahy, MSc^*, Gary S. Mintz, MD, FACC^*, Alexandra J. Lansky, MD, FACC^*,, Jeffrey W. Moses, MD, FACC^*,, Gregg W. Stone, MD, FACC^*,, Martin B. Leon, MD, FACC^*, and George Dangas, MD, PhD, FACC^*,,*

^* Cardiovascular Research Foundation
Columbia University Medical Center, New York, New York

View larger version (24K): [in a new window]   Figure 1 Risk score development dataset. Increasing risk of contrast-induced nephropathy with increasing risk score is evident with inclusion of either baseline serum creatinine value or estimated glomerular filtration rate in the multivariate model. Solid bars = serum creatinine-based model; open bars = estimated glomerular filtration rate-based model.

View larger version (13K): [in a new window]   Figure 2 The contrast-induced nephropathy risk score derived from the development dataset predicted this complication in the validation set, as well. Solid bars = development dataset; open bars = validation dataset.

View larger version (11K): [in a new window]   Figure 3 In-hospital hemodialysis can be predicted by a high or very high risk score value similarly in the development and validation datasets. Solid bars = development dataset; open bars = validation dataset.

View larger version (12K): [in a new window]   Figure 4 The prognostic significance of the proposed risk score for contrast-induced nephropathy extended to prediction of one-year mortality, as indicated by the results obtained from both the development and validation datasets. Solid bars = development dataset; open bars = validation dataset.

View larger version (30K): [in a new window]   Figure 5 Scheme to define contrast-induced nephropathy (CIN) risk score. Anemia = baseline hematocrit value <39% for men and <36% for women; CHF = congestive heart failure class III/IV by New York Heart Association classification and/or history of pulmonary edema; eGFR = estimated glomerular filtration rate; hypotension = systolic blood pressure <80 mm Hg for at least 1 h requiring inotropic support with medications or intra-aortic balloon pump (IABP) within 24 h periprocedurally.