title: Preprocedural N-terminal pro-brain natriuretic peptide (NT-proBNP) is similar to the Mehran contrast-induced nephropathy (CIN) score in predicting CIN following elective coronary angiography.
abstract: BACKGROUND
  N-terminal pro-brain natriuretic peptide (NT-proBNP) has been associated with important risk factors for contrast-induced nephropathy (CIN). However, few studies have investigated the predictive value of NT-proBNP itself. This study investigated whether levels of preprocedural NT-proBNP could predict CIN after elective coronary angiography as effectively as the Mehran CIN score.
  
  
  RESULTS
  We retrospectively observed 2248 patients who underwent elective coronary angiography. The predictive value of preprocedural NT-proBNP for CIN was assessed by receiver operating characteristic and multivariable logistic regression analysis. The 50 patients (2.2%) who developed CIN had higher Mehran risk scores (9.5 ± 5.1 versus 4.8 ± 3.8), and higher preprocedural levels of NT-proBNP (5320 ± 7423 versus 1078 ± 2548 pg/mL, P<0.001). Receiver operating characteristic analysis revealed that NT-proBNP was not significantly different from the Mehran CIN score in predicting CIN (C=0.7657 versus C=0.7729, P=0.8431). An NT-proBNP cutoff value of 682 pg/mL predicted CIN with 78% sensitivity and 70% specificity. Multivariable analysis suggested that, after adjustment for other risk factors, NT-proBNP >682 pg/mL was significantly associated with CIN (odds ratio: 4.007, 95% CI: 1.950 to 8.234; P<0.001) and risk of death (hazard ratio: 2.53; 95% CI: 1.49 to 4.30; P=0.0006).
  
  
  CONCLUSIONS
  Preprocedural NT-proBNP >682 pg/mL was significantly associated with the risk of CIN and death. NT-proBNP, like the Mehran CIN score, may be another useful and rapid screening tool for CIN and death risk assessment, identifying subjects who need therapeutic measures to prevent CIN.
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Y.L., Y.H., N.T., J.C., Y.L., D.Y., S.J.H., P.Y., H.L., P.R., Y.Z.).
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Y.L., Y.H., N.T., J.C., Y.L., D.Y., S.J.H., P.Y., H.L., P.R., Y.Z.) Department of Cardiology, The First People's Hospital of Shunde, Foshan, China (Y.H.).
authors.forename: Yi-ting
authors.initials: YT
authors.lastname: He
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Y.L., Y.H., N.T., J.C., Y.L., D.Y., S.J.H., P.Y., H.L., P.R., Y.Z.).
authors.forename: Ning
authors.initials: N
authors.lastname: Tan
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Y.L., Y.H., N.T., J.C., Y.L., D.Y., S.J.H., P.Y., H.L., P.R., Y.Z.).
authors.forename: Ji-yan
authors.initials: JY
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Y.L., Y.H., N.T., J.C., Y.L., D.Y., S.J.H., P.Y., H.L., P.R., Y.Z.).
authors.forename: Yuan-hui
authors.initials: YH
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Y.L., Y.H., N.T., J.C., Y.L., D.Y., S.J.H., P.Y., H.L., P.R., Y.Z.).
authors.forename: Da-hao
authors.initials: DH
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Y.L., Y.H., N.T., J.C., Y.L., D.Y., S.J.H., P.Y., H.L., P.R., Y.Z.).
authors.forename: Shui-jin
authors.initials: SJ
authors.lastname: Huang
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Y.L., Y.H., N.T., J.C., Y.L., D.Y., S.J.H., P.Y., H.L., P.R., Y.Z.).
authors.forename: Piao
authors.initials: P
authors.lastname: Ye
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Y.L., Y.H., N.T., J.C., Y.L., D.Y., S.J.H., P.Y., H.L., P.R., Y.Z.).
authors.forename: Hua-long
authors.initials: HL
authors.lastname: Li
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Y.L., Y.H., N.T., J.C., Y.L., D.Y., S.J.H., P.Y., H.L., P.R., Y.Z.).
authors.forename: Peng
authors.initials: P
authors.lastname: Ran
authors.affiliation: National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China (C.D., S.C., P.Y.C.).
authors.forename: Chong-yang
authors.initials: CY
authors.lastname: Duan
authors.affiliation: National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China (C.D., S.C., P.Y.C.).
authors.forename: Shi-qun
authors.initials: SQ
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Y.L., Y.H., N.T., J.C., Y.L., D.Y., S.J.H., P.Y., H.L., P.R., Y.Z.).
authors.forename: Ying-ling
authors.initials: YL
authors.lastname: Zhou
authors.affiliation: National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China (C.D., S.C., P.Y.C.).
authors.forename: Ping-yan
authors.initials: PY
authors.lastname: Chen
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003404:Creatinine
keywords: N‐terminal pro‐brain natriuretic peptide; contrast‐induced nephropathy; coronary angiography