Development and Validation of a Pre-Percutaneous Coronary Intervention Risk Model of Contrast-Induced Acute Kidney Injury With an Integer Scoring System

Taku Inohara, Shun Kosaka, Takayuki Abe, Hiroaki Miyata, Yohei Numasawa, Ikuko Ueda, Yutaro Nishi, Kotaro Naito, Masaru Shibata, Kentaro Hayashida, Yuichiro Maekawa, Akio Kawamura, Yuji Sato, Keiichi Fukuda

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Previous models for contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI) include procedure-related variables in addition to pre-procedural variables. We sought to develop a risk model for CI-AKI based on pre-procedural variables and compare its predictability with a conventional risk model and also to develop an integer score system based on selected variables. A total of 5,936 consecutive PCIs registered in the Japanese Cardiovascular Database were analyzed (derivation cohort, n = 3,957; validation cohort, n = 1,979). CI-AKI was defined as an increase in serum creatinine of 50% or 0.3 mg/dl compared with baseline. From the derivation cohort, 2 different CI-AKI risk models were generated using logistic regression analyses: a pre-procedural model and a conventional model including both pre-procedural and procedure-related variables. The predictabilities of the models were compared by c-statistics. An integer score was assigned to each variable in proportion to each estimated regression coefficient for the final model. In our derivation cohort, the proportion of CI-AKI was 9.0% (n = 358). Predictors for CI-AKI included older age, heart failure, diabetes, previous PCI, hypertension, higher baseline creatinine level, and acute coronary syndrome. Presence of procedure-related complications and insertion of intra-aortic balloon pumping were included as procedure-related variables in the conventional model. Both the conventional model (c-statistics 0.789) and the pre-procedural model (c-statistics 0.799) demonstrated reasonable discrimination. The integer risk-scoring method demonstrated good agreement between the expected and observed risks of CI-AKI in the validation cohort. In conclusion, the pre-procedural risk model for CI-AKI had acceptable discrimination compared with the conventional model and may aid in risk stratification of CI-AKI before PCI.

Original languageEnglish
Article number21042
Pages (from-to)1636-1642
Number of pages7
JournalAmerican Journal of Cardiology
Volume115
Issue number12
DOIs
Publication statusPublished - 2015 Jun 15

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Percutaneous Coronary Intervention
Acute Kidney Injury
Creatinine
Intra-Aortic Balloon Pumping
Acute Coronary Syndrome
Research Design
Heart Failure
Logistic Models
Regression Analysis
Databases
Hypertension
Serum

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Development and Validation of a Pre-Percutaneous Coronary Intervention Risk Model of Contrast-Induced Acute Kidney Injury With an Integer Scoring System. / Inohara, Taku; Kosaka, Shun; Abe, Takayuki; Miyata, Hiroaki; Numasawa, Yohei; Ueda, Ikuko; Nishi, Yutaro; Naito, Kotaro; Shibata, Masaru; Hayashida, Kentaro; Maekawa, Yuichiro; Kawamura, Akio; Sato, Yuji; Fukuda, Keiichi.

In: American Journal of Cardiology, Vol. 115, No. 12, 21042, 15.06.2015, p. 1636-1642.

Research output: Contribution to journalArticle

Inohara, Taku ; Kosaka, Shun ; Abe, Takayuki ; Miyata, Hiroaki ; Numasawa, Yohei ; Ueda, Ikuko ; Nishi, Yutaro ; Naito, Kotaro ; Shibata, Masaru ; Hayashida, Kentaro ; Maekawa, Yuichiro ; Kawamura, Akio ; Sato, Yuji ; Fukuda, Keiichi. / Development and Validation of a Pre-Percutaneous Coronary Intervention Risk Model of Contrast-Induced Acute Kidney Injury With an Integer Scoring System. In: American Journal of Cardiology. 2015 ; Vol. 115, No. 12. pp. 1636-1642.
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AU - Kosaka, Shun

AU - Abe, Takayuki

AU - Miyata, Hiroaki

AU - Numasawa, Yohei

AU - Ueda, Ikuko

AU - Nishi, Yutaro

AU - Naito, Kotaro

AU - Shibata, Masaru

AU - Hayashida, Kentaro

AU - Maekawa, Yuichiro

AU - Kawamura, Akio

AU - Sato, Yuji

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