title: Relation of contrast induced nephropathy to new onset atrial fibrillation in acute coronary syndrome.
abstract: Chronic renal failure has been described as a risk factor for the development of atrial fibrillation (AF). The aim of this study was to examine the association between contrast-induced nephropathy (CIN) and new-onset AF in patients with acute coronary syndromes. A total of 1,520 consecutive patients (mean age 67.1 ± 12.7 years) with acute coronary syndromes (34.4% with ST-segment elevation myocardial infarctions) who underwent coronary angiography were studied. CIN was defined as an increase in serum creatinine of 0.5 mg/dl within 72 hours of contrast exposure. The independent effect of AF history (chronic or paroxysmal AF before catheterization) on the development of CIN, as well as the independent effect of CIN on the development of new-onset AF (after catheterization, during the in-hospital phase), were tested by using different logistic regression models. One hundred thirty-nine patients (9.1%) had histories of AF before catheterization (60 with paroxysmal and 79 with chronic AF), and 56 (4.1%) developed new-onset AF after catheterization. Eighty-seven patients (5.7%) had CIN. AF history was a predictor of CIN in univariate analysis (odds ratio 2.19, 95% confidence interval 1.22 to 3.95, p = 0.007) but not in multivariate analysis, after adjusting for confounding variables (odds ratio 1.69, 95% confidence interval 0.89 to 3.22, p = 0.111). In contrast, those with CIN had an increased prevalence of new-onset AF (15.3% vs 3.4%, p <0.001). After adjusting for those variables associated with new-onset AF in the univariate analysis, CIN continued to show a significant association with new-onset AF, with a twofold increased risk (odds ratio 2.45, 95% confidence interval 1.07 to 5.64, p = 0.035). In conclusion, the development of CIN is an independent predictor of new-onset AF in the context of acute coronary syndromes.
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain. Electronic address: raposeiras26@hotmail.com.
authors.forename: Sergio
authors.initials: S
authors.lastname: Raposeiras Roubín
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Rosa Alba
authors.initials: RA
authors.lastname: Abellas-Sequeiros
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Emad
authors.initials: E
authors.lastname: Abu Assi
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Rami Riziq
authors.initials: RR
authors.lastname: Yousef-Abumuaileq
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Moisés
authors.initials: M
authors.lastname: Rodríguez Mañero
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Iglesias Álvarez
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Violeta
authors.initials: V
authors.lastname: González-Salvado
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: González Ferreiro
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Redondo Diéguez
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Raymundo
authors.initials: R
authors.lastname: Ocaranza Sánchez
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Virgós Lamela
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Peña Gil
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: García Acuña
authors.affiliation: Department of Cardiology and Coronary Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: González Juanatey
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000000981:diagnostic imaging*; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology*; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000150:complications* / Q000175:diagnosis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D003287:Contrast Media; D003404:Creatinine