CIN after coronary angiography heralds a higher patient risk for long-term decline in renal function and thus has profound prognostic relevance. CIN is defined as an impairment of renal function measured by an absolute (> 0.5 mg/dl) or relative (> 25%) increase in serum creatinine within 48–72 h after application of iodinated contrast media. Graphic abstractĬontrast-induced nephropathy (CIN) is a major adverse event for patients undergoing cardiac catheterization and is associated with increased mortality. Results for the outcome ‘need for dialysis’ were equivocal. In German patients undergoing coronary angiography, the modern NCDR risk model for predicting contrast-induced nephropathy showed superior discrimination compared to the Mehran model while showing less accurate calibration.
Mehran c-index 0.75, 95% CI 0.66–0.84 p NCDRvsMehran < 0.01), but continuous NRI showed no benefit and calibration analysis revealed an underestimation of dialysis risk. For the prediction of need for dialysis, NCDR-AKI-D also discriminated risk better (c-index 0.85, 95% CI 0.79–0.91 vs.
The NCDR risk model tended to underestimate the risk of CIN, while the Mehran model was more evenly calibrated. The NCDR risk model showed superior risk discrimination for predicting CIN (NCDR c-index 0.75, 95% CI 0.72–0.78 vs. Risk models were compared regarding discrimination (receiver operating characteristic analysis), net reclassification improvement (NRI) and calibration (graphical and statistical analysis). Predictions of Mehran and NCDR-AKI risk models and clinical events of CIN and need for dialysis were assessed in a total of 2067 patients undergoing coronary angiography with or without percutaneous coronary intervention. However, its performance in comparison to more contemporary National Cardiovascular Data Registry-Acute Kidney Injury (NCDR-AKI) risk models remains unknown. The Mehran risk model is the gold-standard for CIN risk prediction. Contrast-induced nephropathy (CIN) is a major adverse event in patients undergoing coronary angiography.
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