ASSESSING IN-HOSPITAL MORTALITY AND PREDICTORS IN PATIENTS WITH CONTRAST-INDUCED NEPHROPATHY FOLLOWING PRIMARY PERCUTANEOUS CORONARY INTERVENTION

Authors

  • Rajesh Kumar National Institute of Cardiovascular Diseases, Karachi-Pakistan https://orcid.org/0000-0002-6580-7193
  • Kheraj Mal National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Abiha Urooj National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Barkha Lohana National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Mohammad Rasool National Institute of Cardiovascular Diseases, Karachi-Pakistan https://orcid.org/0009-0003-6227-7611
  • Muhammad Yousuf Daud National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Kubbra Rahooja National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Maryam Samad National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Uroosa Safdar National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Ali Bin Naseer National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Kalsoom Chachar National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Muhammad Ishaq National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Zahid Ur Rehman National Institute of Cardiovascular Diseases, Karachi-Pakistan
  • Musa Karim National Institute of Cardiovascular Diseases, Karachi-Pakistan

DOI:

https://doi.org/10.55519/JAMC-04-12124

Keywords:

Iodinated contrast media, percutaneous coronary intervention (PCI), contrast-induced nephropathy (CIN), mortality, Pakistan

Abstract

Background: The contrast-induced nephropathy (CIN) is a common complication of primary percutaneous coronary intervention (PCI) it has been reported to be associated with an increased risk of mortality.  The study reported the in-hospital mortality among patients who developed CIN after primary PCI. Methods: This descriptive cross-sectional study was conducted on a sample of consecutive who developed CIN after primary PCI at a tertiary care cardiac hospital in Karachi, Pakistan. The CIN was defined as either a relative increase of 25% or an absolute increase of 0.5 mg/dL in post-procedure serum creatinine within 72 hours. The in-hospital mortality status was recorded and clinical and demographic predictors of in-hospital mortality were identified with the help of binary logistic regression analysis. Results:  In the study sample of 402 patients, 74.1% (298) were male and the mean age of the study sample was 59.4±11.5 years. The in-hospital mortality rate was 9.7% (39). On multivariable analysis, an increased risk of mortality was found to be independently associated with inferior wall myocardial infarction (IWMI) with right ventricular (RV) infarction, intra-procedure arrhythmias, and pump failure with an adjusted odds ratio of 3.63 [95% CI: 1.31-10.08; p=0.013], 5.53 [95% CI: 1.39-22.06; p=0.015], and 8.94 [95% CI: 3.99-20.02; p<0.001], respectively. Conclusion: In conclusion, there is a high rate of mortality for patients who develop CIN after primary PCI, and the risk of mortality is further aggravated by the presence of IWMI with RV infarction, intra-procedure arrhythmias, and pump failure.

Author Biographies

Rajesh Kumar, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Kheraj Mal, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Abiha Urooj, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Barkha Lohana, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Mohammad Rasool, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Muhammad Yousuf Daud, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Kubbra Rahooja, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Maryam Samad, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Uroosa Safdar, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Ali Bin Naseer, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Kalsoom Chachar, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Muhammad Ishaq, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Zahid Ur Rehman, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

Musa Karim, National Institute of Cardiovascular Diseases, Karachi-Pakistan

 

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Published

2023-12-22

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