title: Utility of the Logistic Clinical Syntax Score in the Prediction of Contrast-Induced Nephropathy After Primary Percutaneous Coronary Intervention.
abstract: BACKGROUND
  The Logistic Clinical Syntax Score (log CSS) is a combined risk scoring system that includes clinical and anatomic parameters; it has been found to be effective for the prediction of mortality in patients with ST-elevation myocardial infarction (STEMI). The aim of the present study was to assess whether the log CSS was associated with the development of contrast-induced nephropathy (CIN) in patients who underwent primary percutaneous coronary intervention (pPCI).
  
  
  METHODS
  A total of 930 patients with STEMI undergoing pPCI between January 2012 and August 2013 were included prospectively. The patients were grouped according to the development of CIN. Either an absolute serum creatinine level ≥ 0.5 mg/dL or a 25% increase in the serum creatinine level compared with the baseline level within 48 hours after the administration of contrast medium was defined as CIN.
  
  
  RESULTS
  The Synergy Between Percutaneous Coronary Interventions With Taxus and Cardiac Surgery score (SYNTAX [SS]) and log CSS were higher in patients with CIN than in those without. In the multivariate analysis, log CSS (odds ratio, 1.405, 95% confidence interval, 1.318-1.497; P < 0.001), hemoglobin, and contrast volume were found to be independent predictors of CIN. In the receiver operating characteristic analysis, a log CSS > 9.5 had a 74.5% sensitivity and a 90.5% specificity for predicting CIN, with an area under the curve (AUC) of 0.892, whereas an SS > 18.5 had a 64% sensitivity, a 58.1% specificity, and an AUC of 0.625 (0.892 vs 0.625; P < 0.001). A log CSS > 9.5 was associated with in-hospital and long-term mortality, reinfarction, revascularization, and in-hospital hemodialysis (P < 0.001 for each).
  
  
  CONCLUSIONS
  The log CSS may improve the accuracy of risk stratification for the development of CIN in patients undergoing pPCI.
authors.affiliation: Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. Electronic address: dr.deryaerbas@hotmail.com.
authors.forename: Derya
authors.initials: D
authors.lastname: Ozturk
authors.affiliation: Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Celik
authors.affiliation: Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Erturk
authors.affiliation: Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ali Kemal
authors.initials: AK
authors.lastname: Kalkan
authors.affiliation: Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Uzun
authors.affiliation: Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ibrahim Faruk
authors.initials: IF
authors.lastname: Akturk
authors.affiliation: Department of Cardiology, Mugla Sikti Kocman University Medical Faculty, Mugla, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Akin
authors.affiliation: Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Aydin
authors.initials: A
authors.lastname: Yildirim
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000601:surgery; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
chemical_list: D003287:Contrast Media