Inter-arm blood pressure difference is associated with contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention

ABSTRACT

Objective

Contrast-induced nephropathy (CIN) is a serious complication in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (p-PCI). An interarm systolic blood pressure difference (IASBD) ≥10 mmHg has been identified as an independent risk factor for cardiovascular disease and mortality. The aim of this study was to evaluate the predictive value of the IASBD for the risk of CIN in patients with STEMI who underwent p-PCI.

Method

We prospectively investigated 2120 consecutive patients who were hospitalized with a diagnosis of STEMI and underwent p-PCI. A relative increase in serum creatinine levels of ≥ 25% or an absolute increase of ≥ 0.5 mg/dL from baseline within 72 h of contrast exposure was defined as CIN. The IASBD was calculated on admission to the emergency department. The risk of CIN was evaluated.

Results

The incidence of CIN was 6.6% (n = 139). The patients were divided into 2 groups based on the development of CIN. Age (p = .001), baseline creatinine levels (p < .001), DM (p < .001), HT (p < .001) and anemia (p = .001) were higher in patients with CIN. An IASBD ≥10 mmHg was noted in 13 (9.3%) patients in the CIN group and 83 (4.1%) (p = .001) in the non-CIN group (Table 1). According to the multivariate analysis, the IASBD was found to be a predictor of CIN development (OR: 2.36, 95% CI: 1.42–3.90, p: 0.001).

Conclusion

The IASBD on admission can be a potential predictor of CIN development in patients with STEMI who underwent p-PCI.

KEYWORDS:

• Interarm blood pressure difference
• contrast-induced nephropathy
• ST-segment elevation myocardial infarction

Disclosure statement

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Informed consent

Informed consent has been obtained from all patient for this research.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.