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العنوان
Novel Score for Prediction of Contrast Induced Nephropathy after Percutaneous
Coronary Interventions \
المؤلف
Gafaar, Nourhan Abo EL-Qassim Ahmed.
هيئة الاعداد
باحث / نورهان أبو القاسم أحمد جعفر
مشرف / أحمد محمد فتحي تمارا
مشرف / ايهاب محمد الفقي
مشرف / محمود أحمد طنطاوي
تاريخ النشر
2022.
عدد الصفحات
163 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
أمراض القلب والطب القلب والأوعية الدموية
تاريخ الإجازة
1/1/2022
مكان الإجازة
جامعة عين شمس - كلية الطب - أمراض القلب
الفهرس
Only 14 pages are availabe for public view

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from 163

Abstract

Background:CIN is one of the most important PCI complications with higher mortality so it is important to early detect high risk patients for CIN and prevent it’s occurrence. However, CHA2DS2-VASc score neglects important factors as (S.creatnine, eGFR, Anemia, contrast volume, SBP<80mmhg, IABP) that found in Mehran. Mehran score neglects factors which increase CIN risk as (HTN, Female gender, vascular element, stroke) and found in CHA2DS2-VASc.
Aim: To evaluate a novel score (SPADC2H) for CIN prediction after PCI using variables in MRS, CHADS-VASc scores and PCI urgency to be used on patients with ACS and stable CAD.
Methods: This study is conducted over 500 patients as follow: (Study sample 250 patients, number of population that are experimented for the novel score development, provided that the CIN incidence ranging from7% to25% (average 13.20%) after PCI. Then we validate the score on 250 patients).We analyzed whole patient’s data, CHADSVASc, MRS scores then followed up patient’s creatinine level daily for 48hr after PCI for CIN development then compared these data in CIN versus non CIN patients trying to find out the most independent variables that can predict CIN developing a novel score.
Results: from the 500 patients (n=250study population,250validation).All Variables included in the model for CIN prediction: (Age≥65 years, Female sex, Hypertension, DM, Stroke, HCM, Aortic plaque, Old IHD, TIA, PAD, EF≤40%, Primary PCI, Contrast volume≥200ml, SBP≤80 mmHg, eGFR<60 ml/min, Baseline creatinine>1.5 mg/dl, Anemia).Variables that include: Female gender (p-value=0.009), DM (p-value=0.002), PAD (p-value=0.021), Contrast volume ≥200 ml (p-value=0.060), SBP≤80mmHg or need for inotropes (p-value=0.0005),and baseline creatinine>1.5mg/dl (p-value=0.0005) are retained in the model as significant independent factors. Variables that include:Age≥65years (p-value=0.021,male (p-value=0.004),Hypertension (p-value=0.029), EF≤40% (p-value=0.010),NYHAIII/IV (p-value=0.0185),Primary PCI (p-value=0.037),eGFR<60ml/min (p-value= 0.015) and Anemia (p-value=0.003) are significant variables but are all extruded from the model during stepwise iterations by (multivariable backward binary logistic regression model) as dependent factors for CIN prediction. Variables that include: Stroke (p-value=0.565),DVT (p-value=0.947),Old IHD (p-value=0.616) are non-significant variables. Variables that include: TIA, IABP, HCM, Aortic plaque are limited in the study. IN experimental study (n.250 p.).
Conclusion: Novel simple risk score for CIN prediction. Comparison between the three (MRS, Novel, CHADS-VASC) scores.