Jing Li1, Yi Li1, Xiaozeng Wang1, Shuguang Yang2, Chuanyu Gao3, Zheng Zhang4, Chengming Yang5, Quanming Jing1, Shouli Wang6, Yingyan Ma1, Zulu Wang1, Yanchun Liang1, Yaling Han7. 1. Department of Cardiology, Shenyang Northern Hospital, Shenyang, Liaoning 110016, China. 2. Department of Cardiology, Jinan Military 88th Hospital, Taian, Shandong 271000, China. 3. Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, China. 4. Department of Cardiology, First Affiliated Hospital of Lanzhou University, Lanzhou, Gansu 730000, China. 5. Department of Cardiology, Daping Hospital and the Research Institute of Surgery of the Third Military Medical University, Chongqing 400038, China. 6. Department of Cardiology, The 306th Hospital of People's Liberation Army, Beijing 10000, China. 7. Department of Cardiology, Shenyang Northern Hospital, Shenyang, Liaoning 110016, China. Email: hanyaling@263.net.
Abstract
BACKGROUND: The occurrence of contrast induced acute kidney injury (CIAKI) has a pronounced impact on morbidity and mortality. The aim of the present study was to appraise the diagnostic efficacy of age, estimated glomerular filtration rate (eGFR) and ejection fraction (AGEF) score (age/EF(%)+1 (if eGFR was <60 ml × min(-1)× 1.73 m(-2))) as an predictor of CIAKI in patients with diabetes mellitus (DM) and concomitant chronic kidney disease (CKD). METHODS: The AGEF score was calculated for 2 998 patients with type 2 DM and concomitant CKD who had undergone coronary/peripheral arterial angiography. CIAKI was defined as an increase in sCr concentration of 0.5 mg/dl (44.2 mmol/L) or 25% above baseline at 72 hours after exposure to the contrast medium. Post hoc analysis was performed by stratifying the rate of CIAKI according to AGEF score tertiles. The diagnostic efficacy of the AGEF score for predicting CIAKI was evaluated with receiver operating characteristic (ROC) analysis. RESULTS: The AGEF score ranged from 0.49 to 3.09. The AGEF score tertiles were defined as follows: AGEFlow ≤ 0.92 (n = 1 006); 0.92 <AGEFmid ≤ 1.16 (n = 1 000), and ACEFhigh >1.16 (n = 992). The incidence of CIAKI was significantly different in patients with low, middle and high AGEF scores (AGEFlow = 1.1%, AGEFmid = 2.3% and AGEFhigh = 5.8%, P < 0.001). By multivariate analysis, AGEF score was an independent predictor of CIAKI (odds ratio = 4.96, 95% CI: 2.32-10.58, P < 0.01). ROC analysis showed that the area under the curve was 0.70 (95% CI: 0.648-0.753, P < 0.001). CONCLUSION: The AGEF score is effective for stratifying risk of CIAKI in patients with DM and CKDundergoing coronary/peripheral arterial angiography. (Clinical Trial identifier: NCT00786136).
RCT Entities:
BACKGROUND: The occurrence of contrast induced acute kidney injury (CIAKI) has a pronounced impact on morbidity and mortality. The aim of the present study was to appraise the diagnostic efficacy of age, estimated glomerular filtration rate (eGFR) and ejection fraction (AGEF) score (age/EF(%)+1 (if eGFR was <60 ml × min(-1)× 1.73 m(-2))) as an predictor of CIAKI in patients with diabetes mellitus (DM) and concomitant chronic kidney disease (CKD). METHODS: The AGEF score was calculated for 2 998 patients with type 2 DM and concomitant CKD who had undergone coronary/peripheral arterial angiography. CIAKI was defined as an increase in sCr concentration of 0.5 mg/dl (44.2 mmol/L) or 25% above baseline at 72 hours after exposure to the contrast medium. Post hoc analysis was performed by stratifying the rate of CIAKI according to AGEF score tertiles. The diagnostic efficacy of the AGEF score for predicting CIAKI was evaluated with receiver operating characteristic (ROC) analysis. RESULTS: The AGEF score ranged from 0.49 to 3.09. The AGEF score tertiles were defined as follows: AGEFlow ≤ 0.92 (n = 1 006); 0.92 <AGEFmid ≤ 1.16 (n = 1 000), and ACEFhigh >1.16 (n = 992). The incidence of CIAKI was significantly different in patients with low, middle and high AGEF scores (AGEFlow = 1.1%, AGEFmid = 2.3% and AGEFhigh = 5.8%, P < 0.001). By multivariate analysis, AGEF score was an independent predictor of CIAKI (odds ratio = 4.96, 95% CI: 2.32-10.58, P < 0.01). ROC analysis showed that the area under the curve was 0.70 (95% CI: 0.648-0.753, P < 0.001). CONCLUSION: The AGEF score is effective for stratifying risk of CIAKI in patients with DM and CKD undergoing coronary/peripheral arterial angiography. (Clinical Trial identifier: NCT00786136).