Abstract 12716: Is Pre Existing Atrial Fibrillation a Risk Factor for Contrast Induced Nephropathy After Cardiac Catheterization?
Introduction: Identifying patients at risk is an important step in preventing contrast-induced nephropathy (CIN). Several risk factors have been previously identified. We investigated to determine the association of pre-existing atrial fibrillation (AF) with the development of CIN after cardiac catheterization.
Methods: A retrospective chart review of 513 patients who underwent cardiac catheterization from June to December 2014 was done. Patients with end-stage renal disease (n=38) & without pre-procedural serum creatinine (n=57) were excluded. Serum creatinine before the procedure & each day for three days after the procedure was recorded. CIN was defined as an increase in serum creatinine by ≥25% or ≥0.5mg/dl from the pre-procedural value within 72 hours of contrast exposure. Chronic kidney disease (CKD) was defined as eGFR <60ml/min calculated by modified diet in renal disease equation. Use of ICD 9 codes for atrial fibrillation & congestive heart failure (CHF) in admission medical records was defined as pre-existing AF & CHF.
Results: A total of 418 patients (mean age 69.1 ± 13.8, 55% male and 45% female) were included in the study. 13% of patients had pre-existing AF, 27.9% had CHF & 19.6% had CKD. 16 patients of the total 418 developed CIN. The mean incidence of CIN in the population studied was 3.8%. Higher incidence of CIN was seen in AF, CHF & CKD groups when tested by univariate analysis & chi-squared test. The incidence of CIN was 13.8% in AF group Vs. 2.3% in non-AF group (p<0.001), 8.6% in CHF group Vs. 1.9% in non-CHF group (p<0.01) & 8.9% CKD group Vs. 2.4 % in non-CKD group (p<0.002). In multivariate logistic regression analysis, development of CIN was strongly associated with pre-existing AF. AF had odds ratio (OR) 4.11, 95% confidence interval (CI) 1.40-12.07, p=0.01. CHF had OR = 2.67, 95% CI, 0.89-7.98, p=0.08. CKD had OR=3.94, 95% CI, (1.56-9.98), p=0.04.
Conclusions: Pre-existing atrial fibrillation may have an association with higher risk of CIN after cardiac catheterization in addition to conventional risk factors.
Author Disclosures: Y. Sedhai: None. T. Choksi: None. A. Asija: None. W. Ahangar: None. D. Gevorgyan: None. R. Golamari: None. M. Borikar: None. J. Missri: None.
- © 2016 by American Heart Association, Inc.