The predictive value of hemoglobin to creatinine ratio for contrast-induced nephropathy in percutaneous coronary interventions.

OBJECTIVES: Hemoglobin and creatinine levels are important factors for contrast induced nephropathy (CIN) development. Our aim in this study is to investigate the predictive value of hemoglobin to creatinine ratio for CIN development in patients with percutaneous coronary intervention (PCI). METHODS: A total of 500 patients who underwent PCI in our clinic were evaluated prospectively in terms of CIN. Hemoglobin to creatinine ratio is calculated as baseline hemoglobin/baseline serum creatinine value. glomerular filtration rate (GFR) was calculated with Cockcroft-Gault formula. The definition of CIN includes absolute (≥0.5 mg/dL) or relative increase (≥25%) in serum creatinine at 48-72 h after exposure to a contrast agent compared to baseline serum creatinine values. RESULTS: CIN was detected in 13.8% (69 patients) of 500 patients. In multivariate lineer regression analysis, hemoglobin to creatinine ratio (beta: -0.227, p=0.03) and ejection fraction (EF) (beta: -0.161, p<0.001), contrast amount used (beta: 0.231, p<0.001) were found to be significant predictors for the development of CIN. In receiver operating characteristics (ROC) analysis; AUC=0.730 (0.66-0.79) for hemoglobin to creatinine ratio, p<0.001, AUC=0.694 (0.62-0.76) for EF, p<0.001 and AUC=0.731 (0.67-0.78) for contrast amount used p<0.001. CONCLUSIONS: Hemoglobin to creatinine ratio, EF and contrast amount used were independent predictors for CIN development in patients with PCI (NCT04703049).

The effect of whole blood viscosity on contrast-induced nephropathy development in patients undergoing percutaneous coronary intervention.

OBJECTIVE: In our study, we aimed to investigate how whole blood viscosity (WBV) affects the development of contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary intervention (PCI). METHODS: In our study, 500 patients who applied to the cardiology clinic and underwent PCI for elective procedure, ST segment elevation myocardial infarction (STEMI), and non-STEMI were prospectively included. Before the procedure, we calculated WBV using the formula [(0.12× hematocrit) + (0.17×(total protein - 2.07)]. We defined CIN as the absolute (≥0.5 mg/dl) or relative increase (≥25%) in serum creatinine 48-72 h after exposure to a contrast agent compared with baseline serum creatinine values. RESULTS: CIN was developed in 69 (13.6%) of the 500 patients in the study. PCI was performed in 206 patients (41.2%) electively, 175 (35%) due to non-STEMI, and 119 (23%) due to STEMI. CIN was observed in 20.2% of the STEMI group, 13.7% of the non-STEMI group, and 10.2% of the elective PCI group. Multivariate logistic regression analysis results show that the independent predictors of CIN are low ejection fraction [OR:0.95 (95% CI:0.92-0.97); p < 0.001], low glomerular filtration rate [OR:0.96 (95% CI:0.95-0.98); p < 0.001], and increased amount of contrast agent [OR:1.008 (95% CI:1.004-1.01); p < 0.001]. When all patients were examined, no significant relationship was found between WBV and CIN. However, in the subgroup evaluation, it was concluded that low WBV was an independent predictor in elective PCI patients [OR:0.60 (95% CI:0.36-0.99); p = 0.04] for CIN. CONCLUSION: We found that low WBV was an independent predictor of CIN in patients undergoing elective PCI(NCT04703049).