SIGNIFICANCE OF CANADA ACUTE CORONARY SYNDROME RISK SCORE IN EMERGENCY PERCUTANEOUS REVASCULARIZATION FOR THE PREDICTION OF CONTRAST INDUCED NEPHROPATHY

Authors

  • Ashok Kumar National Institute of Cardiovascular Diseases (NICVD), Hyderabad, Pakistan
  • Kahkashan Zehra Naqvi National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Shueeta Kumari National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Rajesh Kumar National Institute of Cardiovascular Diseases Karachi, Pakistan
  • Muhammad Tariq Farman Dow University of Health Sciences (DUHS), Karachi, Pakistan
  • Shahid Ahmed National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Samra Kazmi Dow University of Health Sciences, Karachi, Pakistan
  • Muhammad Murtaza National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Omesh Kumar National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Jawaid Akbar Sial National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Tahir Saghir National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan

DOI:

https://doi.org/10.47144/phj.v55i2.2232

Abstract

Objectives: This study was conducted to compare the accuracy of Canada Acute Coronary Syndrome (C-ACS) score against Mehran risk score (MRS) in primary percutaneous coronary intervention (PCI) patients for risk stratification of contrast induced nephropathy (CIN) at a tertiary care cardiac hospital.

Methodology: In this study we included adult patients presented with chief presenting complaint of typical chest pain to emergency department within 12 hours of onset of symptoms, diagnosed with ST-segment elevation myocardial infarction (STEMI) and taken to the catheterization laboratory for primary PCI. Two scores MRS and C-ACS were computed and CIN was defined based on the variations in creatinine level, absolute 0.5 mg/dL or relative 25% increase at 48-72 hours.

Results: Study included a total of 593 patients with mean age of 52.22±11.1 years and 488(82.3%) were male patients. A total of 53(8.9%) patients developed CIN after primary PCI. The area under the curve (AUC) was 0.745 [0.675-0.815] and 0. 647 [0.560-0.733] for MRS and C-ACS score respectively. The threshold value C-ACS ≥ 1 has sensitivity of 47.2% [33.3%-61.4%] and specificity of 80.2% [76.6%-83.5%]. Similarly, MRS ≥6.5 has sensitivity of 64.2% [49.8%-76.9%] and specificity of 75% [71.1%-78.6%].

Conclusion: C-ACS score is found to be less sensitive but more specific in identifying patients at high risk of CIN. Predictive value of C-ACS was observed to be lower than that of MRS. In the tradeoff of simplicity and accuracy, clinicians may consider accuracy and prefer MRS over C-ACS for the risk stratification of CIN.

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Published

2022-07-05

How to Cite

1.
Kumar A, Naqvi KZ, Kumari S, Kumar R, Farman MT, Ahmed S, Kazmi S, Murtaza M, Kumar O, Sial JA, Saghir T. SIGNIFICANCE OF CANADA ACUTE CORONARY SYNDROME RISK SCORE IN EMERGENCY PERCUTANEOUS REVASCULARIZATION FOR THE PREDICTION OF CONTRAST INDUCED NEPHROPATHY. Pak Heart J [Internet]. 2022Jul.5 [cited 2024Mar.3];55(2):124-8. Available from: https://www.pakheartjournal.com/index.php/pk/article/view/2232

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Original Article