Association between elevated CHA2DS2-VASC score and contrast-induced nephropathy among patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis

Abstract

Background

Promising results with the CHA₂DS₂-VASc risk score (CVRS) have been reported for the prediction of contrast-induced nephropathy (CIN). The aim of this study is to consolidate all the data available and examine the association between elevated CVRS and the incidence of CIN in patients undergoing percutaneous coronary intervention (PCI).

Methods

We systematically searched PubMed, Embase, and Scopus for abstracts and full-text articles from inception to May 2022. Studies were included if they evaluated the association between a high CVRS and the incidence of CIN in patients undergoing PCI. Data were integrated using the random-effects, generic inverse variance method of DerSimonian and Laird. Prospero registration: CRD42022334065.

Results

Seven studies from 2016 to 2021 with a total of 7,401 patients were included. In patients undergoing PCI, a high CVRS (≥2: Odds ratio [OR]:2.98, 95% confidence interval [95% CI] 2.25–3.94, p < .01, I² = 1%, ≥3: OR 4.46, 95% CI 2.27–8.78, p < .01, I²=56% and ≥4: OR:2.75, 95% CI 1.76–4.30, p < .01, I² = 11%) was significantly associated with an increase incidence for CIN. Subgroup analyses were done in patients with acute coronary syndrome, and association with CIN remained statistically significant (≥2: OR 2.93, 95% CI 2.11–4.07, p < .01, I²=22%and ≥4: OR:2.24, 95% CI 1.36–3.69, p < .01, I² = 0%,).

Conclusion

In patients undergoing PCI, an elevated CVRS is associated with an increased risk for CIN. More rigorous studies are needed to clarify this association and to identify strategies to reduce CIN.

Keywords:

• CHA2DS2-VASC score
• contrast induced nephropathy
• percutaneous coronary intervention
• acute coronary syndrome
• risk score
• meta-analysis
• systematic review

Ethics statement

An ethics statement is not applicable because this study is based exclusively on published literature.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data is available in the manuscript.

Additional information

Funding

The authors have no funding sources to declare.