Serum creatinine ratio: A novel predictor of mortality after percutaneous coronary intervention in patients with normal and abnormal renal function
- 15 June 2009
- journal article
- research article
- Published by Wiley in Catheterization and Cardiovascular Interventions
- Vol. 74 (1), 49-55
- https://doi.org/10.1002/ccd.21946
Abstract
The occurrence of contrast induced nephropathy (CIN) is associated with increased mortality after percutaneous revascularization procedures. However, the exact correlation between various levels of creatinine elevation relative to the baseline and subsequent mortality in patients with chronic renal insufficiency (CRI) is not well established. In addition, the relationship between elevated postprocedural creatinine and ensuing mortality in patients with normal baseline renal function needs to be investigated. Methods: All percutaneous coronary intervention (PCI) patients (n = 12,997) were analyzed for any rise in serum creatinine (SCr): CRI group (BSC ≥ 1.5 mg/dl) (n = 1,853) and normal baseline renal function (NBR BSC < 1.5 mg/dl) group (n = 11,144). Patients in each group were analyzed for any elevation in SCr postprocedure and subdivided based on the SCr ratio [peak SCr/Baseline creatinine (BSC)] of 1.5. The overall incidence of CIN (defined as an increment of 25% over baseline creatinine) was 5.9%: 11.3% in the CRI group versus 5.1% in normal BSC group (P < 0.01). Recursive partitioning and Cox hazard modeling were used to assess significant variables associated with mortality within 1 year. Only serum creatinine ratio (SCrR) > 1.5 correlated with increased mortality in both CRI group as well as normal BSC group. Conclusions: SCrR > 1.5 predicts mortality at 1 year after PCI. The association between SCrR > 1.5 and increased mortality at follow-up is observed in patients with CRI as well as normal baseline renal function. SCrR may thus serve as a useful clinical tool for risk stratification and prognostication of patients after PCI.Keywords
This publication has 13 references indexed in Scilit:
- Transient and persistent renal dysfunction are predictors of survival after percutaneous coronary intervention: Insights from the Dartmouth Dynamic RegistryCatheterization and Cardiovascular Interventions, 2008
- A Comparison of Contemporary Definitions of Contrast Nephropathy in Patients Undergoing Percutaneous Coronary Intervention and a Proposal for a Novel Nephropathy Grading SystemThe American Journal of Cardiology, 2008
- Pathophysiology of contrast medium–induced nephropathyKidney International, 2005
- Hospital-acquired renal insufficiencyAmerican Journal of Kidney Diseases, 2002
- Weight Gain Continues in the 1990s: 10-year Trends in Weight and Overweight from the CARDIA StudyAmerican Journal of Epidemiology, 2000
- PREPARED: PREParation for Angiography in REnal DysfunctionChest, 1998
- Scraping of aortic debris by coronary guiding cathetersJournal of the American College of Cardiology, 1998
- Acute Renal Failure After Coronary InterventionAmerican Journal Of Medicine, 1997
- Effects of Saline, Mannitol, and Furosemide on Acute Decreases in Renal Function Induced by Radiocontrast AgentsNew England Journal of Medicine, 1994
- Metaanalysis of the relative nephrotoxicity of high- and low-osmolality iodinated contrast media.Radiology, 1993