Сontrast-induced acute kidney injury in patients with acute coronary syndrome without ST-segment elevation after diagnostic coronary angiography

Introduction: the frequency and risk factors of contrast-induced acute kidney injury (CI AKI) after coronary angiography (CAG) or coronary stenting have been evaluated by several major studies. The purpose of this study: to determine the frequency and risk factors for the development of CI-AKI in patients with acute coronary syndrom (ACS) without ST-segment elevation after diagnostic coronary angiography. Material and methods: a retrospective analysis of 104 cases of patients admitted with the diagnosis of ACS without ST-segment elevation was performed, including 42 women (40%) and 62 men (60%). The average age of the patients was 66 (60; 73) years. Glomerular filtration rate before diagnostic coronary angiography was determined using the CKD-EPI formula (eGFR). CI-AKI was diagnosed when the serum creatinine (Scr) level increased by more than 26.5 μM within 48 hours compared to the baseline level. Results: the initial level of eGFR<60 ml/min/1.73 m2 was found in 25% of patients. In the subgroup of patients with eGFR<60 ml/min/1.73 m2, women of older age prevailed. In 6 patients (6%), the level of creatinine gain after CAG met the criteria for CI-AKI. In the subgroup of patients with eGFR ≥60 ml/min/1.73 m2, the relative number of patients with CI-AKI was 6.4%, in the subgroup of patients with eGFR<60 ml/min/1.73 m2 it was 3.8%. Statistically significant differences between patients with the development of CI-AKI and without CI-AKI were found for age and NYHA functional class III CHF. Conclusions: a quarter of patients with ACS without ST-segment elevation initially have eGFR <60 ml/min/1.73 m2. CI-AKI was developed in 6% of patients after the diagnostic CAG. The risk factors for CI-AKI in patients with ACS, according to the data obtained, were old age and chronic heart failure (CHF) of high functional class according to NYHA.

острое повреждение почек, контраст-индуцированное острое повреждение почек, ишемическая болезнь сердца, острый коронарный синдром, коронароангиография, acute kidney injury, contrast-induced acute kidney injury, coronary heart disease, acute coronary syndrome, coronary angiography

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