CONTRAST-INDUCED ACUTE KIDNEY INJURY: THE SIN OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION

Objective: To determine frequency of contrast-induced nephropathy (CIN), and post procedure complications in-hospital mortality in patients after undergoing Primary Percutaneous Coronary Intervention for acute ST-Elevation Myocardial Infarction (STEMI). Methodology: This cross sectional study includes patients, who underwent primary percutaneous coronary intervention at NICVD Karachi from 8th October 2016 to 7th April 2017. Rise of at least 0.5 mg/dL in serum creatinine level or a 25% increase from baseline within forty-eight to seventy-two hours after contrast administration was used as criteria for contrast induced nephropathy. Demographic characteristics, clinical history, presentation, post procedural complications, and in-hospital mortality in CIN and non-CIN group were assessed and compared. Results: Of 282 patients 69.86% (197) were males with mean age of 54.77 +/- 11.18 years. Contrast-induced nephropathy was observed in 12.41% (35) patients. Proportion of female patients was significantly higher in CIN group. Diabetes, hypertension and CKD remain the major risk factors. Amount of contrast used, serum creatinine, length of hospital stay, and mortality were significantly higher in CIN group. After the adjustments for potential effect modifiers the only statistically significant factors were found to be female gender and contrast used >= 200ml (p= 0.012 and 0.01 respectively). Conclusion: CIN after primary PCI is strongly and positively associated with female gender, hypertension, chronic kidney disease, diabetes mellitus, presence of shock and more than 200 ml of contrast use.