Contrast-induced nephropathy after staged percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease

Background Contrast-induced nephropathy(CIN) occurs frequently in patients undergoing primary percutaneous coronary intervention(PCI) for ST-segment elevation myocardial infarction(STEMI) and is associated with poor outcomes. Multivessel coronary artery disease(MVCAD) is considered to be a potentially important risk factor for CIN. There are still no data on CIN in patients undergoing staged PCI for STEMI and MVCAD. Therefore, we explored the incidence, risk factors, in-hospital and follow-up outcomes of CIN in this special population. Methods From 2011 to 2018, we enrolled 103 consecutive patients with STEMI who underwent staged PCI for MVCAD. CIN was defined as a relative increase of > 25% or an absolute increase of ≥ 0.5 mg/dL in SCr from the baseline value 72 h after exposure to the contrast medium. The incidence, risk factors, in-hospital and follow-up outcomes of CIN in this special population were studied. Results We found1) the incidence of CIN after primary PCI and staged PCI was 16.50% and 25.20%, respectively. 2) patients with CIN had worse in-hospital and follow-up outcomes. 3) in multivariate logistic analysis, independent risk factors for CIN included:(1) lower creatinine clearance at baseline;(2) atrioventricular block requiring temporary cardiac pacemaker implantation;(3) use of IABP at baseline;(4) total contrast volume administered( primary PCI +staged PCI);(5) shorter time interval between primary PCI and staged PCI. Conclusions CIN is a frequent complication in patients with STEMI and MVCAD undergoing staged PCI. The development of CIN is associated with worse in-hospital and follow-up outcomes.