Mehran and AGEF Risk Scores in Contrast-Induced Nephropathy Among Patients Undergoing Primary Percutaneous Coronary Intervention

Abstract
Background: Primary percutaneous coronary intervention (PCI) is the treatment of choice for ST-segment elevation myocardial infarction (STEMI). Contrast induced nephropathy (CIN) is a serious complication which complicates PCI, resulting in increased morbidity, hospital stay, short and long term adverse outcomes. Prediction of high risk patients for development of CIN is of great importance to conduct pre-ventive measures. Various scoring systems were developed to set up high risk criteria.
Aim of Study: To detect the relation between Mehran and AGEF risk scores and CIN. Also, to report other high risk criteria to predict CIN.
Patients and Methods: The study included 250 patients with acute STEMI treated by primary PCI. Patients with coronary anatomy not suitable for PCI, with pre-existing renal troubles, on chronic dialysis and who need urgent coronary artery by-pass surgery were excluded.
Results: CIN developed among 90 patients (36%). There was no significant association between CIN and patients' age or weight. The independent predictors of the occurrence of CIN were, in order, Mehran score (OR=6.4), Diabetes (OR= 5.8), AGEF score (OR=3.3) creatinine clearance (OR=1.02), non-osmolar contrast volume (OR=0.991). Females, those with low ejection fraction (EF) or previous history of is-chemic heart disease (IHD) were susceptible for CIN.
Conclusion: CIN is a challenging health problem among patients undergoing primary PCI. Mehran risk score has a better predictive power that AGEF score in predicting CIN. Several other factors are associated with CIN development like diabetes, female gender, low EF history of IHD and use of non-osmolar contrast.