Open AccessVALIDITY OF MEHRAN RISK SCORE FOR PREDICTING CONTRAST INDUCED NEPHROPATHY IN MODERN PRIMARY PERCUTANEOUS CORONARY INTERVENTIONS ERA
Author(s) -
Rajesh Kumar,
Tarique Ahmed,
Shahzad Khatti,
Aziz-ur Rehman Memon,
Noor Ahmed Shaikh,
Fawad Farooq,
Zille Huma,
Shahzad Hussain,
Jawaid Akbar Sial,
Tahir Saghir
Publication year - 2022
Publication title -
pakistan heart journal
Language(s) - English
Resource type - Journals
eISSN - 2227-9199
pISSN - 0048-2706
DOI - 10.47144/phj.v55i1.2183
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , contrast induced nephropathy , odds ratio , cardiology , creatinine , killip class , myocardial infarction , surgery
Objectives: Contrast induced nephropathy (CIN) is a common complication and found to be associated with increased morbidity and mortality after primary percutaneous coronary intervention (PCI). The objective of this study was to validate the Mehran Risk Score (MRS) for the risk stratification of CIN in patients undergone primary PCI.Methodology: A cohort of consecutive patients undergone primary PCI at a tertiary care cardiac center were included for this study. Patients in Killip class IV at presentation, patents history of any PCI, and chronic kidney diseases were excluded from this study. MRS was calculated at baseline and post procedure serum creatinine level increase of either 25% or 0.5 mg/dL was taken as CIN.Results: A total of 547 patients were included, of which 79.3%(434) were male. CIN after primary PCI was observed in 62(11.3%) patients. The area under the curve (AUC) for the MRS was 0.712 [0.641 to 0.783]. Cut-off value of ≥6.5 had sensitivity of 61.3% [48.1%-73.4%] with positive predictive value of 21.2% [17.5%-25.6%] and specificity of 70.9% [66.7%-74.9%] with negative predictive value of 93.5% [91.3%-95.2%]. MRS ≥6.5 was found to be an independent predictor on multivariable analysis with adjusted odds ratios (OR) of 3.86 [2.23-6.68] along with multi-vessel diseases with OR of 2.31 [1.27-4.19].Conclusion: MRS has shown to have a good discriminating power. However low positive predictive value of the optimal cutoff value of ≥6.5 for prediction of CIN suggests need of modification to the MRS to improve its clinical utility in the modern era of primary PCI.