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  • Title: Preprocedural N-terminal pro-brain natriuretic peptide (NT-proBNP) is similar to the Mehran contrast-induced nephropathy (CIN) score in predicting CIN following elective coronary angiography.
    Author: Liu Y, He YT, Tan N, Chen JY, Liu YH, Yang DH, Huang SJ, Ye P, Li HL, Ran P, Duan CY, Chen SQ, Zhou YL, Chen PY.
    Journal: J Am Heart Assoc; 2015 Apr 17; 4(4):. PubMed ID: 25888371.
    Abstract:
    BACKGROUND: N-terminal pro-brain natriuretic peptide (NT-proBNP) has been associated with important risk factors for contrast-induced nephropathy (CIN). However, few studies have investigated the predictive value of NT-proBNP itself. This study investigated whether levels of preprocedural NT-proBNP could predict CIN after elective coronary angiography as effectively as the Mehran CIN score. METHODS AND RESULTS: We retrospectively observed 2248 patients who underwent elective coronary angiography. The predictive value of preprocedural NT-proBNP for CIN was assessed by receiver operating characteristic and multivariable logistic regression analysis. The 50 patients (2.2%) who developed CIN had higher Mehran risk scores (9.5 ± 5.1 versus 4.8 ± 3.8), and higher preprocedural levels of NT-proBNP (5320 ± 7423 versus 1078 ± 2548 pg/mL, P<0.001). Receiver operating characteristic analysis revealed that NT-proBNP was not significantly different from the Mehran CIN score in predicting CIN (C=0.7657 versus C=0.7729, P=0.8431). An NT-proBNP cutoff value of 682 pg/mL predicted CIN with 78% sensitivity and 70% specificity. Multivariable analysis suggested that, after adjustment for other risk factors, NT-proBNP >682 pg/mL was significantly associated with CIN (odds ratio: 4.007, 95% CI: 1.950 to 8.234; P<0.001) and risk of death (hazard ratio: 2.53; 95% CI: 1.49 to 4.30; P=0.0006). CONCLUSIONS: Preprocedural NT-proBNP >682 pg/mL was significantly associated with the risk of CIN and death. NT-proBNP, like the Mehran CIN score, may be another useful and rapid screening tool for CIN and death risk assessment, identifying subjects who need therapeutic measures to prevent CIN.
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