title: Combination of hemoglobin and left ventricular ejection fraction as a new predictor of contrast induced nephropathy in patients with non-ST elevation myocardial infarction.
abstract: BACKGROUND
  Hemoglobin concentration (Hb) and left ventricular ejection fraction (EF) are known predictors of contrast induced nephropathy (CIN). We hypothesized that combination of Hb concentration and left ventricular EF is superior to either variable alone in predicting contrast induced nephropathy in patients with acute coronary syndrome (ACS).
  
  
  METHODS
  Consecutive patients with ACS were prospectively enrolled. Patients considered for invasive strategy were included. Baseline creatinine levels were detected on admission and 24, 48 and 72 hours after coronary intervention. 25% or 0,5 umol/L increase in creatinine level was considered as CIN.
  
  
  RESULTS
  268 patients with ACS (mean age 58±11 years, 77% male) were enrolled. Contrast induced nephropathy was observed in 26 (9.7%) of patients. Baseline creatinine concentration, left ventricular EF, and Hemoglobin was significantly different between two groups. Contrast volume to estimated glomerular filtration rate ratio (OR: 1.310, 95% CI: 1.077-1.593, p=0.007) and the combination of Hb and left ventricular EF (OR: 0.996, 95% CI: 0.994-0.998, p=0.001) were found to be independent predictors for CIN. Hb × LVEF ≤690 had 85% sensitivity and 57% specificity to predict CIN (area under curve: 0.724, 95% CI: 0.625-0.824, p<0.001). In addition, Hb × LVEF ≤690 had a negative predictive value of 97% in our analysis
  
  
  CONCLUSIONS
  The combination of Hb and left ventricular EF is better than either variable alone at predicting CIN in patients with ACS that undergone percutaneous coronary intervention. The prediction was independent of baseline renal function and volume of contrast agent.
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ugur
authors.affiliation: Clinic of Cardiology, Kadirli State Hospital, Osmaniye, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Uluganyan
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ekmekci
authors.affiliation: Department of Cardiology, Marmara University Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bozbay
authors.affiliation: Clinic of Cardiology, Osmancik Government Hospital, Corum, Turkey.
authors.forename: Gurkan
authors.initials: G
authors.lastname: Karaca
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Cicek
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Bayram
authors.initials: B
authors.lastname: Koroglu
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Eyup
authors.initials: E
authors.lastname: Tusun
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Murat
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Turan
authors.affiliation: Clinic of Cardiology, Bezmialem Vakif University Medical Hospital, Istanbul, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Uyarel
authors.affiliation: Clinic of Cardiology, Medeniyet University Medical Hospital, Istanbul, Turkey.
authors.forename: Ahmet Lutfi
authors.initials: AL
authors.lastname: Orhan
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eren
mesh_terms: D003287:Contrast Media / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology*; D012372:ROC Curve; D013318:Stroke Volume
chemical_list: D003287:Contrast Media; D006454:Hemoglobins