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Predictive Value of CHA2DS2-VASc-HSF Score for Contrast Induced Nephropathy After Percutaneous Coronary Intervention for Acute Myocardial Infarction

Author : H.W. Parlindungan, R. Hasan, C. A. Andra, H. Hasan, A. A. Siregar, I. N. Kaoy, Z. Mukhtar, A.N. Nasu
Upload Date : 19-04-2018

Background: The CHA2DS2-VASc score, used for embolic risk stratification in atrial fibrillation (AF), has been reported recently to predict adverse clinical outcomes so is Contrast Induced Nephropathy (CIN) in patients with AMI regardless of having AF. We used a formulated score CHA2DS2-VASc-HSF which included more variable like Hyperlipidemia (H), Smoker (S), and Family History of CAD (F) in addition to the previous risk factor to assess the risk of CAD. We investigated these score as multivariable risk assessment tools to the predict CIN events in acute myocardial infarction patients who underwent percutaneous coronary intervention (PCI) strategies.

Methods: Consecutive sampling was performed in 53 patients with acute myocardial infarction, admitted in Haji Adam Malik General Hospital, Medan, from January 2017 to December 2017 who underwent PCI strategies. We exclude patients with hypotension state during PCI or using any inotropic for stabilizing haemodynamic, cardiogenic shock, atrial fibrillation,  and patients with post cardiac resuscitation. CIN was defined as the elevation of serum creatinine > 0,5 mg/dl or > 25% in baseline serum creatinine within 24 hours after PCI.

Results: In the ROC curve analysis,the cut-off value of CHA2DS2-VASc-HSF score in the prediction of CIN was > 5 (sensitivity:78.5%, Specificity:66.6%) (AUC 0.818, 95% CI 1.739-31.25, p=0.001). CIN (+) was found to be higher among patients with CHA2DS2-VASc-HSF score > 5 (n=11 {78.6%}) vs score < 5 (n=3 {21.4%}). From logistic regression test, we also predict the probability events percentage of CIN (+) and CIN (-) with total CHA2DS2-VASc-HSF Score from AMI patients who underwent the PCI strategies.

Conclusion: The CHA2DS2-VASc-HSF score was positively associated with CIN. Therefore, this score can be used as a simple and reliable tools to predict CIN in AMI patients who underwent PCI.

KEYWORDS : CHA2DS2-VASc-HSF score, Contrast Induced Nephropathy, AMI, PCI

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