Can Thrombus Burden Predict Contrast-Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction?. (August 2019)

• Record Type: Journal Article
• Authors: Sigirci, Serhat; Keskin, Kudret; Yildiz, Süleyman Sezai; Cetinkal, Gökhan; Gurdal, Ahmet; Kilci, Hakan; Tezcan, Mehmet; Kilickesmez, Kadriye Orta
• Is Part Of: Angiology. Volume 70:Number 7(2019)
• Page Start: 642
• Page End: 648
• Publication Date: 2019-08
• Subjects: kidney injury -- acute coronary syndrome -- platelet reactivity -- thrombus score -- contrast-induced nephropathy; Blood-vessels -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.13005
• DOI: 10.1177/0003319718822638
• Languages: English
• ISSNs: 0003-3197

Abstract

The incidence of contrast-induced nephropathy (CIN) increases in the range from patients with unstable angina to ST-segment elevation myocardial infarction (STEMI). Platelet activation has been associated with pathophysiology of nephropathy and thrombus burden in the infarct-related arteries. We investigated the impact of thrombus burden on CIN in patients with STEMI. We enrolled 883 patients with STEMI who received primary percutaneous coronary intervention. Patients were divided into groups according to thrombus burden and CIN development. Thrombus burden was scored based on thrombolysis in myocardial infarction thrombus grades (TGs). Thrombus grade 4 was defined as large thrombus burden (LTB), while thrombus burden <TG 4 was defined as small thrombus burden. A total of 126 (14.2%) patients with STEMI had CIN, while 313 (35.4%) patients had LTB. Compared to CIN (−) patients, CIN (+) patients were older, had lower hemoglobin levels, lower ejection fraction, and higher contrast media volume administration. Multivariate logistic regression analysis demonstrated that LTB, age, hypertension, and admission glomerular filtration rate were independent predictors of CIN ( P = .016, P < .001, P = .028, P < .001, respectively). Thrombus burden, which is measurable during angiography, may be helpful in the determination of CIN risk in patients with STEMI.