A simple nomogram to predict contrast-induced acute kidney injury in patients with congestive heart failure undergoing coronary angiography

Autor:	Silin Chen, Zhiqiang Guo, J.T Liu, L Lei, Yuan-hui Liu, Jiyan Chen, Yi-ting He, Z Nie, B Liu
Rok vydání:	2020
Předmět:	Coronary angiography medicine.medical_specialty business.industry Acute kidney injury Nomogram medicine.disease Internal medicine Heart failure Area under curve Cardiology Medicine In patient Cardiology and Cardiovascular Medicine business Killip class
Zdroj:	European Heart Journal. 41
ISSN:	1522-9645 0195-668X
DOI:	10.1093/ehjci/ehaa946.2554
Popis:	Background Patients with congestive heart failure (CHF) are vulnerable to contrast-induced acute kidney injury (CI-AKI), but few prediction models are currently available. Objectives We aimed to establish a simple nomogram for CI-AKI risk assessment for patients with CHF undergoing coronary angiography. Methods A total of 1876 consecutive patients with CHF (defined as New York Heart Association functional class II-IV or Killip class II-IV) were enrolled and randomly (2:1) assigned to a development cohort and a validation cohort. The endpoint was CI-AKI defined as serum creatinine elevation of ≥0.3 mg/dL or 50% from baseline within the first 48–72 hours following the procedure. Predictors for the nomogram were selected by multivariable logistic regression with a stepwise approach. The discriminative power was assessed using the area under the receiver operating characteristic (ROC) curve and was compared with the classic Mehran score in the validation cohort. Calibration was assessed using the Hosmer–Lemeshow test and 1000 bootstrap samples. Results The incidence of CI-AKI was 9.06% (n=170) in the total sample, 8.64% (n=109) in the development cohort and 9.92% (n=61) in the validation cohort (p=0.367). The simple nomogram including four predictors (age, intra-aortic balloon pump, acute myocardial infarction and chronic kidney disease) demonstrated a similar predictive power as the Mehran score (area under the curve: 0.80 vs 0.75, p=0.061), as well as a well-fitted calibration curve. Conclusions The present simple nomogram including four predictors is a simple and reliable tool to identify CHF patients at risk of CI-AKI, whereas further external validations are needed. Figure 1 Funding Acknowledgement Type of funding source: None
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::2d3675ab8dcc31a06e2ab8297867e8ae https://doi.org/10.1093/ehjci/ehaa946.2554 Zobrazit plný text záznamu