CHADS2-VASC Score as a Predictor for Contrast Induced Nephropathy in Patient with Acute Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention

Abstract
Background: Ischaemic heart disease is the single most common cause of death and its frequency is increasing. Acute ST-Elevation Myocardial Infarction (STEMI) results from the sudden obstruction of a coronary artry. Acute kidney injury is a frequent complication among patients who undergo Primary Percutaneous Intervention (PCI) shown to be associ-ated with adverse outcomes. CHADS2 and the more recent CHA2DS2-VASc are two validated scores for predicting embolic/stroke risk in patients with non-valvular Atrial Fibril-lation (AF). The CHADS2-VASC score has been reported as risk factors for CIN and adverse cardiac events.
Aim of the Study: The aim of this work is to evaluate CHA2DS2-VASC score as a predictor for Contrast-Induced Nephropathy (CIN) in patient with acute myocardial infarction treated with primary Percutaneous Coronary Intervention (PCI).
Patient and Methods: The study included 100 patients presenting to Cardiology Department, Tanta University Hos-pital, diagnosed with as first time STEMI and underwent primary PCI. CHADS2-VASC score (age, sex, diabetes, hypertension, heart failure on admission, previous ischemic event, vascular event) was calculated for all patients. Serum creatinin level and effective Glomerular Filtration Rate (eGFR) were estimated for all patient before and 48h after PPCI.
They were divided into into two groups: Group I: Those who developed CIN 48h after primary PCI (36%) and Group II: Those who did not (64%).
Results: Patient who developed CIN had higher CHADS2- VASC score than who did not, mean ± SD value was 3.53±1.11 vs. 0.72±0.83, p-value <0.001.
Conclusion: CHA2DS2-VASC score >3 was independently associated with CIN development in patients with acute STEMI who were treated by PPCI. The more CHADS2-VASC score, the more risk for developing CIN after PPCI.