title: A novel risk score model for prediction of contrast-induced nephropathy after emergent percutaneous coronary intervention.
abstract: BACKGROUND
  A few studies developed simple risk model for predicting CIN with poor prognosis after emergent PCI. The study aimed to develop and validate a novel tool for predicting the risk of contrast-induced nephropathy (CIN) in patients undergoing emergent percutaneous coronary intervention (PCI).
  
  
  METHODS
  692 consecutive patients undergoing emergent PCI between January 2010 and December 2013 were randomly (2:1) assigned to a development dataset (n=461) and a validation dataset (n=231). Multivariate logistic regression was applied to identify independent predictors of CIN, and established CIN predicting model, whose prognostic accuracy was assessed using the c-statistic for discrimination and the Hosmere Lemeshow test for calibration.
  
  
  RESULTS
  The overall incidence of CIN was 55(7.9%). A total of 11 variables were analyzed, including age >75years old, baseline serum creatinine (SCr)>1.5mg/dl, hypotension and the use of intra-aortic balloon pump(IABP), which were identified to enter risk score model (Chen). The incidence of CIN was 32(6.9%) in the development dataset (in low risk (score=0), 1.0%, moderate risk (score:1-2), 13.4%, high risk (score≥3), 90.0%). Compared to the classical Mehran's and ACEF CIN risk score models, the risk score (Chen) across the subgroup of the study population exhibited similar discrimination and predictive ability on CIN (c-statistic:0.828, 0.776, 0.853, respectively), in-hospital mortality, 2, 3-years mortality (c-statistic:0.738.0.750, 0.845, respectively) in the validation population.
  
  
  CONCLUSIONS
  Our data showed that this simple risk model exhibited good discrimination and predictive ability on CIN, similar to Mehran's and ACEF score, and even on long-term mortality after emergent PCI.
authors.affiliation: Southern Medical University, Guangzhou 510515, China; Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China; Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Provincial Institute of Clinical Geriatrics, Fujian Provincial Key Laboratory of Geriatric Disease, Fujian Medical University, Fuzhou 350001, China.
authors.forename: Kai-Yang
authors.initials: KY
authors.lastname: Lin
authors.affiliation: Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Provincial Institute of Clinical Geriatrics, Fujian Provincial Key Laboratory of Geriatric Disease, Fujian Medical University, Fuzhou 350001, China.
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Zheng
authors.affiliation: Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China.
authors.forename: Wei-Jie
authors.initials: WJ
authors.lastname: Bei
authors.affiliation: Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China.
authors.forename: Shi-Qun
authors.initials: SQ
authors.lastname: Chen
authors.affiliation: The George Institute for Global Health, University of Sydney, Camperdown, NSW, 2050, Australia.
authors.forename: Sheikh Mohammed Shariful
authors.initials: SM
authors.lastname: Islam
authors.affiliation: Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. Electronic address: liuyongmd@126.com.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. Electronic address: drxue@hotmail.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Xue
authors.affiliation: Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. Electronic address: tanning100@126.com.
authors.forename: Ning
authors.initials: N
authors.lastname: Tan
authors.affiliation: Southern Medical University, Guangzhou 510515, China; Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. Electronic address: chenjiyandr@126.com.
authors.forename: Ji-Yan
authors.initials: JY
authors.lastname: Chen
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000601:surgery*; D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D000072657:ST Elevation Myocardial Infarction / Q000401:mortality / Q000601:surgery*
chemical_list: D003287:Contrast Media
keywords: Acute coronary syndromes; Contrast-induced nephropathy; Emergent percutaneous coronary intervention; Risk score model