Factors Predictive of Contrast-induced Acute Kidney Injury in the Setting of Coronary No-reflow Phenomenon

İngilizce (OpenAlex)

Introduction: In subjects undergoing percutaneous coronary intervention (PCI), coronary no-reflow phenomenon is generally determined through evaluation of TIMI (Thrombolysis In Myocardial Infarction) score. Contrast-induced acute kidney injury (CI-AKI) has also been a frequent problem in these patients. The purpose of this study is aimed to evaluate potential risk factors of CI-AKI in subjects with coronary no-reflow phenomenon. Methods: We enrolled consecutive patients with coronary artery disease (CAD) undergoing PCI between the years 2014 and 2019 in cardiology clinic. Independent variables associated with CI-AKI in patients with no reflow phenomenon following PCI were evaluated using multivariate logistic regression analysis. A p value <0.05 was accepted as the statistical significance limit. Results: Among a population of 3034 patients, 93 (3%) were diagnosed as having coronary no-reflow (64% male, mean age of 64±12 years). CI-AKI occurred in 22% of the patients with coronary no-reflow (n:20). The multivariate analysis has demonstrated significant associations of post PCI TIMI flow 0-1, contrast volume and pulmonary arterial hypertension (PHT) with the evolution of CI-AKI in the setting of no-reflow phenomenon (p:0.023, p:0.017 and p<0.001). Conclusion: In CAD patients managed with PCI, PHT, contrast volume, post-PCI TIMI flow as well as the presence of coronary ectasia may pose a significant risk for CI-AKI development in subjects with coronary no-reflow phenomenon.