Contrast-induced acute kidney injury in patients with myocardial infarction non obstruction and with coronary artery obstruction

Goal. To conduct a comparative assessment of renal function, risk factors and the incidence of contrast-induced nephropathy (CIN) in patients with MINOCA and MICAD, including taking into account the value of the left ventricular global function index (LVGFI).Material and methods. The study involved...

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Main Authors: I. S. Grishin, N. I. Maksimov, N. S. Grishina
Format: Article
Language:Russian
Published: InterMedservice 2025-03-01
Series:Евразийский Кардиологический Журнал
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Online Access:https://www.heartj.asia/jour/article/view/6497
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author I. S. Grishin
N. I. Maksimov
N. S. Grishina
author_facet I. S. Grishin
N. I. Maksimov
N. S. Grishina
author_sort I. S. Grishin
collection DOAJ
description Goal. To conduct a comparative assessment of renal function, risk factors and the incidence of contrast-induced nephropathy (CIN) in patients with MINOCA and MICAD, including taking into account the value of the left ventricular global function index (LVGFI).Material and methods. The study involved 170 patients diagnosed with myocardial infarction. The diagnosis was established in accordance with the Fourth Universal Definition. According to the results of coronary angiography (CAG), patients were divided into 2 groups: 1 – myocardial infarction without coronary artery obstruction (MINOCA), n=73,2 – myocardial infarction with coronary artery obstruction (MICAD), n=97, who, according to indications, underwent stenting of the infarct-associated coronary artery. According to the magnitude of the LVGFI, patients are divided into 2 subgroups: 1 – low LVGFI (<31,2%), 2 – normal LVGFI (>31,2%). The glomerular filtration rate (GFR) was estimated according to the formula CKD – Epi 2011 at admission, 24 hours and 48 hours after the procedure. The CIN criterion is an increase in serum creatinine levels by 26,5 mmol/l or more within 48 hours after administration of an X-ray contrast agent (RVC).Results. In patients with MICAD, the risk of AKI CIN is the same. Patients with MICAD required a higher amount of PCI (89.8 ml, p<0.001). The estimated risk of CIN, taking into account the amount of RCF used, is higher in patients with low LVGFI in the MICAD group (6.5 points versus 4 points, p=0.028). Patients with MINOCA with LVGFI >31.2% required a larger volume of PCI (200 ml and 199 ml in patients with LVGFI <31.2%, p=0.041). Patients with CIN in the MINOCA group tended to have higher creatinine (110 and 92 mmol/L, p=0.08). No differences in the main risk factors were found in patients with MICAD who had and had not had acute kidney injury due to contrast-induced nephropathy.Conclusion. The risk and prevalence of AKI are the same in patients with MINOKA and MICAD. Patients with MICAD needed more RCB. Depending on the LVGFI value, renal function, the occurrence of risk factors for acute kidney injury, and the prevalence of CIN OP did not differ. Patients with MINOCA with CIN had higher pre-procedure creatinine levels.
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spelling doaj-art-e7033b76b9464228b3112e605b3034ef2025-08-20T03:37:31ZrusInterMedserviceЕвразийский Кардиологический Журнал2225-16852305-07482025-03-0101222810.38109/2225-1685-2025-1-22-286371Contrast-induced acute kidney injury in patients with myocardial infarction non obstruction and with coronary artery obstructionI. S. Grishin0N. I. Maksimov1N. S. Grishina2Izhevsk State Medical AcademyIzhevsk State Medical AcademyRepublican Clinical Diagnostic Center of the Ministry of Health of the Udmurt RepublicGoal. To conduct a comparative assessment of renal function, risk factors and the incidence of contrast-induced nephropathy (CIN) in patients with MINOCA and MICAD, including taking into account the value of the left ventricular global function index (LVGFI).Material and methods. The study involved 170 patients diagnosed with myocardial infarction. The diagnosis was established in accordance with the Fourth Universal Definition. According to the results of coronary angiography (CAG), patients were divided into 2 groups: 1 – myocardial infarction without coronary artery obstruction (MINOCA), n=73,2 – myocardial infarction with coronary artery obstruction (MICAD), n=97, who, according to indications, underwent stenting of the infarct-associated coronary artery. According to the magnitude of the LVGFI, patients are divided into 2 subgroups: 1 – low LVGFI (<31,2%), 2 – normal LVGFI (>31,2%). The glomerular filtration rate (GFR) was estimated according to the formula CKD – Epi 2011 at admission, 24 hours and 48 hours after the procedure. The CIN criterion is an increase in serum creatinine levels by 26,5 mmol/l or more within 48 hours after administration of an X-ray contrast agent (RVC).Results. In patients with MICAD, the risk of AKI CIN is the same. Patients with MICAD required a higher amount of PCI (89.8 ml, p<0.001). The estimated risk of CIN, taking into account the amount of RCF used, is higher in patients with low LVGFI in the MICAD group (6.5 points versus 4 points, p=0.028). Patients with MINOCA with LVGFI >31.2% required a larger volume of PCI (200 ml and 199 ml in patients with LVGFI <31.2%, p=0.041). Patients with CIN in the MINOCA group tended to have higher creatinine (110 and 92 mmol/L, p=0.08). No differences in the main risk factors were found in patients with MICAD who had and had not had acute kidney injury due to contrast-induced nephropathy.Conclusion. The risk and prevalence of AKI are the same in patients with MINOKA and MICAD. Patients with MICAD needed more RCB. Depending on the LVGFI value, renal function, the occurrence of risk factors for acute kidney injury, and the prevalence of CIN OP did not differ. Patients with MINOCA with CIN had higher pre-procedure creatinine levels.https://www.heartj.asia/jour/article/view/6497contrast-induced nephropathymyocardial infarction without coronary artery obstructionmyocardial infarction with coronary artery obstructionglomerular filtration rateglobal function indexmyocardial infarction
spellingShingle I. S. Grishin
N. I. Maksimov
N. S. Grishina
Contrast-induced acute kidney injury in patients with myocardial infarction non obstruction and with coronary artery obstruction
Евразийский Кардиологический Журнал
contrast-induced nephropathy
myocardial infarction without coronary artery obstruction
myocardial infarction with coronary artery obstruction
glomerular filtration rate
global function index
myocardial infarction
title Contrast-induced acute kidney injury in patients with myocardial infarction non obstruction and with coronary artery obstruction
title_full Contrast-induced acute kidney injury in patients with myocardial infarction non obstruction and with coronary artery obstruction
title_fullStr Contrast-induced acute kidney injury in patients with myocardial infarction non obstruction and with coronary artery obstruction
title_full_unstemmed Contrast-induced acute kidney injury in patients with myocardial infarction non obstruction and with coronary artery obstruction
title_short Contrast-induced acute kidney injury in patients with myocardial infarction non obstruction and with coronary artery obstruction
title_sort contrast induced acute kidney injury in patients with myocardial infarction non obstruction and with coronary artery obstruction
topic contrast-induced nephropathy
myocardial infarction without coronary artery obstruction
myocardial infarction with coronary artery obstruction
glomerular filtration rate
global function index
myocardial infarction
url https://www.heartj.asia/jour/article/view/6497
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AT nimaksimov contrastinducedacutekidneyinjuryinpatientswithmyocardialinfarctionnonobstructionandwithcoronaryarteryobstruction
AT nsgrishina contrastinducedacutekidneyinjuryinpatientswithmyocardialinfarctionnonobstructionandwithcoronaryarteryobstruction