Risk factors of nephropathy contrast in patients with acute coronary syndrome undergoing coronary angiography

Abstract

BACKGROUND: Coronary angiography is a crucial procedure in assessing acute coronary syndrome (ACS), but it carries the risk of nephropathy contrast, especially in hospitalized patients. Risk factors for nephropathy contrast, such as diabetes, hypertension, anemia, and non-steroidal anti-inflammatory drugs (NSAIDs) use, should be evaluated before coronary angiography in ACS patients.METHODS: This nested case-control study involved ACS patients undergoing angiography at Wahidin Sudirohusodo Makassar Teaching Hospital from January 2023 to 2024. The study included 397 subjects, of which 86.4% were males. Sampling was consecutive, and data were analyzed using SPSS software.RESULTS: Diabetes mellitus (DM) was present in 27.7%, hypertension in 50.1%, and dyslipidemia in 23.4% of subjects, with a mean left ventricular ejection fraction (LVEF) of 43.1%. Significant associations were found with age, systolic and diastolic blood pressure, and hemoglobin levels. Cut-offs of 60 years for age, 120 mmHg for systolic blood pressure (SBP), 80 mmHg for diastolic blood pressure (DBP), and 14.0 for hemoglobin (Hb) were determined using receiver operating characteristic (ROC) curves. Multivariate analysis identified age ≥60 years (odds ratio [OR]=3.8), SBP<120 mmHg (OR=2.2), and low Hb<8 mg/dL (OR=2.1) as significant risk factors.CONCLUSIONS: In addition to assessing prior kidney disorders, each contrast angiography in ACS patients should consider age ≥60 years, SBP<120 mmHg, and low hemoglobin levels before the procedure.

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