Predictors of Contrast-Induced Acute Kidney Injury in Patients With Acute Coronary Syndrome
Overview
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Karaganda Medical University
- Enrollment
- 88
- Locations
- 1
- Primary Endpoint
- Change in serum creatinine at 90 days
Overview
Brief Summary
This observational study aims to identify predictors of contrast-induced acute kidney injury (CI-AKI) in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Clinical, laboratory, and procedural factors will be analyzed to determine their association with the development of CI-AKI. The findings may help improve risk stratification and preventive strategies in this high-risk population.
Detailed Description
This prospective observational study investigates predictors of contrast-induced acute kidney injury (CI-AKI) among patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). The study was conducted from November 2024 to June 2025 at a tertiary cardiac center.
Patients with ACS who underwent coronary angiography or PCI were enrolled consecutively. Clinical characteristics, laboratory parameters, hydration status, use of nephrotoxic drugs, and type and volume of contrast media were recorded. Serum creatinine levels were measured before and 48-72 hours after contrast exposure, and CI-AKI was defined according to KDIGO criteria.
The primary objective is to identify independent predictors of CI-AKI using multivariate analysis. Secondary objectives include evaluation of short-term outcomes, such as in-hospital complications and renal function recovery at 90 days. The results are expected to improve understanding of CI-AKI risk in real-world ACS patients and to support preventive strategies in interventional cardiology.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age ≥ 18 years
- •Diagnosis of acute coronary syndrome (STEMI or NSTEMI) confirmed by clinical, ECG, and laboratory findings
- •Undergoing coronary angiography or percutaneous coronary intervention with intravascular contrast administration
- •Provided informed consent to participate in the study
- •Availability of baseline and follow-up serum creatinine values
Exclusion Criteria
- •Known chronic kidney disease stage 4 or 5 (eGFR \< 30 mL/min/1.73 m²) or on dialysis
- •Hemodynamic instability not related to acute coronary syndrome (e.g., septic shock)
- •Exposure to intravenous contrast within the previous 7 days
- •Use of nephrotoxic drugs (e.g., aminoglycosides, amphotericin B) within 72 hours prior to contrast exposure
- •Active infection or inflammatory disease affecting renal function
- •Pregnancy or breastfeeding
- •Refusal or inability to provide informed consent
Outcomes
Primary Outcomes
Change in serum creatinine at 90 days
Time Frame: 90 days after contrast exposure
Change in serum creatinine level compared to baseline at 90-day follow-up after contrast exposure, to evaluate renal function recovery or persistent impairment.
Incidence of Contrast-Induced Acute Kidney Injury (CI-AKI)
Time Frame: Within 72 hours after contrast exposure
Occurrence of contrast-induced acute kidney injury (CI-AKI) defined as an increase in serum creatinine of ≥0.3 mg/dL (≥26.5 µmol/L) or ≥50% from baseline within 48-72 hours after exposure to iodinated contrast media, according to KDIGO criteria.
Secondary Outcomes
- Changes in plasma TIMP-2 concentration(2 hours after contrast exposure)