Mehran vs. Mehran2 pre-procedure: which score better predicts risk of contrast-induced acute kidney injury in patients with acute coronary syndrome?

Background Contrast-induced acute kidney injury (CI-AKI) is a significant concern during percutaneous coronary intervention (PCI) procedures. The novel Mehran 2 pre-procedural risk score, an updated version of the original Mehran score, shows promise as a predictive tool. However, its effectiveness...

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Main Authors: Matheus Santos Moitinho, Dulce Barbosa, Attilio Galhardo, Adriano Caixeta, Eduesley Santana-Santos, Maximina Cunha, Beatriz Santana Prado, Cassiane Dezoti da Fonseca
Format: Article
Language:English
Published: PeerJ Inc. 2025-04-01
Series:PeerJ
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Online Access:https://peerj.com/articles/19166.pdf
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author Matheus Santos Moitinho
Dulce Barbosa
Attilio Galhardo
Adriano Caixeta
Eduesley Santana-Santos
Maximina Cunha
Beatriz Santana Prado
Cassiane Dezoti da Fonseca
author_facet Matheus Santos Moitinho
Dulce Barbosa
Attilio Galhardo
Adriano Caixeta
Eduesley Santana-Santos
Maximina Cunha
Beatriz Santana Prado
Cassiane Dezoti da Fonseca
author_sort Matheus Santos Moitinho
collection DOAJ
description Background Contrast-induced acute kidney injury (CI-AKI) is a significant concern during percutaneous coronary intervention (PCI) procedures. The novel Mehran 2 pre-procedural risk score, an updated version of the original Mehran score, shows promise as a predictive tool. However, its effectiveness specifically in acute coronary syndrome (ACS) patients requires further investigation. This study aims to evaluate the performance of Mehran 2 pre-procedure risk score compared to original score in predicting CI-AKI risk in acute coronary syndrome patients undergoing PCI. Material and Methods A prospective cohort study was conducted with patients with ACS undergoing PCI, who were followed up for 90 days (December 2019–February 2021). The Mehran 2 CI-AKI risk score with pre-procedure data was compared with the original Mehran score. Receiver operating characteristic (ROC) curve and area under the ROC curve (AUC-ROC) were used to evaluate the discriminative capacity. Results 192 patients were analyzed and 33% (n = 64) developed CI-AKI. CI-AKI outcome was associated with advanced age, arterial hypertension, chronic kidney disease, troponin T, hemodynamic instability, serum hemoglobin, serum creatinine, and higher both Mehran scores. Both scores demonstrated good agreement. The original Mehran score demonstrated superior CI-AKI stratification with higher sensitivity (85.94%) and specificity (60.16%) compared to the Mehran 2 pre-procedural score (sensitivity 50%, specificity 75%). Significant differences were observed in the discriminative performance between both scores. Conclusion Sociodemographic, clinical, and laboratory variables were associated with CI-AKI. The original Mehran score demonstrated more consistent discriminative capacity for predicting CI-AKI risk in ACS patients undergoing PCI compared to the Mehran 2 pre-procedural score.
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spelling doaj-art-ce82da39a22e4899a476b849065c582a2025-08-20T03:18:02ZengPeerJ Inc.PeerJ2167-83592025-04-0113e1916610.7717/peerj.19166Mehran vs. Mehran2 pre-procedure: which score better predicts risk of contrast-induced acute kidney injury in patients with acute coronary syndrome?Matheus Santos Moitinho0Dulce Barbosa1Attilio Galhardo2Adriano Caixeta3Eduesley Santana-Santos4Maximina Cunha5Beatriz Santana Prado6Cassiane Dezoti da Fonseca7Paulista Nursing School, Federal University of Sao Paulo, Sao Paulo, BrazilPaulista Nursing School, Federal University of Sao Paulo, Sao Paulo, BrazilQuebec Heart and Lung Institute, Laval University, Quebec City, Quebec, CanadaPaulista Medical School, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, BrazilNursing Post Graduate Program, Federal University of Sergipe, Sao Cristovao, BrazilPaulista Nursing School, Federal University of Sao Paulo, Sao Paulo, BrazilClinical Research Department, Hospital Sírio-Libanês, São Paulo, São Paulo, BrazilPaulista Nursing School, Federal University of Sao Paulo, Sao Paulo, BrazilBackground Contrast-induced acute kidney injury (CI-AKI) is a significant concern during percutaneous coronary intervention (PCI) procedures. The novel Mehran 2 pre-procedural risk score, an updated version of the original Mehran score, shows promise as a predictive tool. However, its effectiveness specifically in acute coronary syndrome (ACS) patients requires further investigation. This study aims to evaluate the performance of Mehran 2 pre-procedure risk score compared to original score in predicting CI-AKI risk in acute coronary syndrome patients undergoing PCI. Material and Methods A prospective cohort study was conducted with patients with ACS undergoing PCI, who were followed up for 90 days (December 2019–February 2021). The Mehran 2 CI-AKI risk score with pre-procedure data was compared with the original Mehran score. Receiver operating characteristic (ROC) curve and area under the ROC curve (AUC-ROC) were used to evaluate the discriminative capacity. Results 192 patients were analyzed and 33% (n = 64) developed CI-AKI. CI-AKI outcome was associated with advanced age, arterial hypertension, chronic kidney disease, troponin T, hemodynamic instability, serum hemoglobin, serum creatinine, and higher both Mehran scores. Both scores demonstrated good agreement. The original Mehran score demonstrated superior CI-AKI stratification with higher sensitivity (85.94%) and specificity (60.16%) compared to the Mehran 2 pre-procedural score (sensitivity 50%, specificity 75%). Significant differences were observed in the discriminative performance between both scores. Conclusion Sociodemographic, clinical, and laboratory variables were associated with CI-AKI. The original Mehran score demonstrated more consistent discriminative capacity for predicting CI-AKI risk in ACS patients undergoing PCI compared to the Mehran 2 pre-procedural score.https://peerj.com/articles/19166.pdfPercutaneous coronary interventionCardiovascular outcomesRenal function
spellingShingle Matheus Santos Moitinho
Dulce Barbosa
Attilio Galhardo
Adriano Caixeta
Eduesley Santana-Santos
Maximina Cunha
Beatriz Santana Prado
Cassiane Dezoti da Fonseca
Mehran vs. Mehran2 pre-procedure: which score better predicts risk of contrast-induced acute kidney injury in patients with acute coronary syndrome?
PeerJ
Percutaneous coronary intervention
Cardiovascular outcomes
Renal function
title Mehran vs. Mehran2 pre-procedure: which score better predicts risk of contrast-induced acute kidney injury in patients with acute coronary syndrome?
title_full Mehran vs. Mehran2 pre-procedure: which score better predicts risk of contrast-induced acute kidney injury in patients with acute coronary syndrome?
title_fullStr Mehran vs. Mehran2 pre-procedure: which score better predicts risk of contrast-induced acute kidney injury in patients with acute coronary syndrome?
title_full_unstemmed Mehran vs. Mehran2 pre-procedure: which score better predicts risk of contrast-induced acute kidney injury in patients with acute coronary syndrome?
title_short Mehran vs. Mehran2 pre-procedure: which score better predicts risk of contrast-induced acute kidney injury in patients with acute coronary syndrome?
title_sort mehran vs mehran2 pre procedure which score better predicts risk of contrast induced acute kidney injury in patients with acute coronary syndrome
topic Percutaneous coronary intervention
Cardiovascular outcomes
Renal function
url https://peerj.com/articles/19166.pdf
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