title: Risk scoring system to predict contrast induced nephropathy following percutaneous coronary intervention.
abstract: BACKGROUND
  Contrast induced nephropathy (CIN) is associated with significant morbidity and mortality after percutaneous coronary intervention (PCI). The aim of this study is to evaluate the collective probability of CIN in Indian population by developing a scoring system of several identified risk factors in patients undergoing PCI.
  
  
  METHODS
  This is a prospective single center study of 1200 consecutive patients who underwent PCI from 2008 to 2011. Patients were randomized in 3:1 ratio into development (n = 900) and validation (n = 300) groups. CIN was defined as an increase of ≥25% and/or ≥0.5 mg/dl in serum creatinine at 48 hours after PCI when compared to baseline value. Seven independent predictors of CIN were identified using logistic regression analysis - amount of contrast, diabetes with microangiopathy, hypotension, peripheral vascular disease, albuminuria, glomerular filtration rate (GFR) and anemia. A formula was then developed to identify the probability of CIN using the logistic regression equation.
  
  
  RESULTS
  The mean (±SD) age was 57.3 (±10.2) years. 83.6% were males. The total incidence of CIN was 9.7% in the development group. The total risk of renal replacement therapy in the study group is 1.1%. Mortality is 0.5%. The risk scoring model correlated well in the validation group (incidence of CIN was 8.7%, sensitivity 92.3%, specificity 82.1%, c statistic 0.95).
  
  
  CONCLUSIONS
  A simple risk scoring equation can be employed to predict the probability of CIN following PCI, applying it to each individual. More vigilant preventive measures can be applied to the high risk candidates.
authors.affiliation: Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India. Electronic address: sumavictor@yahoo.com.
authors.forename: Suma M
authors.initials: SM
authors.lastname: Victor
authors.affiliation: Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Anand
authors.initials: A
authors.lastname: Gnanaraj
authors.affiliation: Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: VijayaKumar
authors.initials: V
authors.lastname: S
authors.affiliation: Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Deshmukh
authors.affiliation: Norwich Clinical Services, Bangalore, India.
authors.forename: Mani
authors.initials: M
authors.lastname: Kandasamy
authors.affiliation: Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Ezhilan
authors.initials: E
authors.lastname: Janakiraman
authors.affiliation: Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Ulhas M
authors.initials: UM
authors.lastname: Pandurangi
authors.affiliation: Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: K
authors.initials: K
authors.lastname: Latchumanadhas
authors.affiliation: Institute of Kidney Diseases, Urology and Organ Transplantation, Madras Medical Mission, India.
authors.forename: Georgi
authors.initials: G
authors.lastname: Abraham
authors.affiliation: Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India.
authors.forename: Ajit S
authors.initials: AS
authors.lastname: Mullasari
mesh_terms: D015415:Biomarkers / Q000097:blood; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D011446:Prospective Studies; D017582:Renal Replacement Therapy; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D003287:Contrast Media
keywords: Coronary intervention; High risk patients; Renal dysfunction