title: Contrast-induced nephropathy after primary angioplasty for acute myocardial infarction.
abstract: BACKGROUND
  The prevention of contrast-induced nephropathy (CIN) is difficult in emergency situations, making it essential to study CIN in patients submitted to urgent angioplasty.
  
  
  OBJECTIVE
  To determine the incidence and associated factors to CIN in patients with myocardial infarction (MI) submitted to primary angioplasty in the first 12 hours after onset of symptoms.
  
  
  METHODS
  We studied 201 consecutive cases of MI with ST-segment elevation with less than 12 hours of evolution. All patients were submitted to the same angioplasty protocol. CIN was defined as an absolute increase of creatinine of at least 0.5 mg/dL and/or a relative increase of creatinine of 25% in relation to baseline in a period between 48 and 72 hours after contrast administration. The variables that differed between patients with and without CIN in univariate analysis were analyzed by logistic regression.
  
  
  RESULTS
  The sample was formed by 135 (67.2%) men and 66 (32.8%) women, with mean age of 66.6 ± 11.7 years. The incidence of CIN was 23.8%. In univariate analysis the patients with CIN were older and had higher frequency of left ventricular ejection fraction ≤ 40% and Killip classification ≥ 2. In multivariate analysis, we did not find independent predictors of CIN.
  
  
  CONCLUSIONS
  CIN occurred in ¼ of the patients with MI submitted to angioplasty without predictor variables. This finding highlights the need for CIN preventive measures after contrast use in emergency angioplasty.
authors.affiliation: Universidade Federal do Ceará, Brazil.
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Santos
authors.affiliation: Universidade Federal do Ceará, Brazil.
authors.forename: Joaquim David
authors.initials: JD
authors.lastname: Carneiro Neto
authors.affiliation: Universidade Federal do Ceará, Brazil.
authors.forename: Francisco Plácido Nogueira
authors.initials: FP
authors.lastname: Arcanjo
authors.affiliation: Hospital do Coração da Santa Casa de Misericórdia de Sobral, Brazil.
authors.forename: José Klauber Roger
authors.initials: JK
authors.lastname: Carneiro
authors.affiliation: Universidade Federal do Ceará, Brazil.
authors.forename: Regina Coeli de Carvalho Porto
authors.initials: RC
authors.lastname: Carneiro
authors.affiliation: Universidade Federal do Ceará, Brazil.
authors.forename: Camila Lopes
authors.initials: CL
authors.lastname: do Amaral
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D003404:Creatinine