Association Between N‐Terminal Pro‐Brain Natriuretic Peptide Levels and Contrast‐Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome

Background Contrast‐induced nephropathy ( CIN ) is associated with significantly increased morbidity and mortality after percutaneous coronary intervention ( PCI ). Patients with acute coronary syndrome ( ACS ) are at higher risk for CIN . N‐terminal pro‐brain natriuretic peptide ( NT‐proBNP ) is closely linked to the prognosis as a strong predictor of both short‐ and long‐term mortality in patients with ACS . Hypothesis We hypothesized that NT‐proBNP levels on admission can predict the development of CIN after PCI for ACS. Methods A total of 436 patients (age 62.27 ± 13.01 years; 64.2% male) with ACS undergoing PCI enrolled in this study. Admission NT‐proBNP levels were measured before PCI . Serum creatinine values were measured before and within 72 hours after the administration of contrast agents. Patients were divided into 2 groups: CIN group and no‐ CIN group. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/ dL or ≥25% above baseline within 72 hours after contrast administration. Results CIN developed in 63 patients (14.4%). Baseline NT‐proBNP levels were significantly higher in patients who developed CIN compared to those who did not develop CIN (median 774 pg/ mL , interquartile range 177.4–2184 vs median 5159 pg/ mL , interquartile range 2282–9677, respectively; P < 0.001). Multivariate analysis found that NT‐proBNP (odds ratio [ OR ]: 3.448, 95% confidence interval [ CI ]: 1.394‐8.474, P = 0.007) and baseline creatinine ( OR : 6.052, 95% CI : 1.860‐19.686, P = 0.003) were independent predictors of CIN . Conclusions Admission NT‐proBNP level is an independent predictor of the development of CIN after PCI in ACS .