Factors predictive of contrast-induced acute kidney injury in the setting of coronary no-reflow phenomenon

Gökay Taylan, Çağlar Kaya, Cihan Öztürk, İlhan Kılıç, Kenan Yalta

Keywords: Coronary no-reflow phenomenon, coronary intervention, coronary artery disease, contrast-induced acute kidney injury

Aim:

In subjects undergoing percutaneous coronary intervention (PCI), the coronary no-reflow phenomenon is generally determined through evaluation of TIMI (Thrombolysis In Myocardial Infarction) score. Contrast-induced acute kidney injury (CI-AKI) has also been a frequent problem in these patients. In the present study, we aimed to evaluate potential risk factors for the evolution of CI-AKI in subjects with the coronary no-reflow phenomenon.

Method:

We retrospectively enrolled consecutive patients with coronary artery disease (CAD) undergoing PCI between the years 2015 and 2020 in our cardiology clinics. Multivariate logistic regression analysis further evaluated the independent variables associated with CI-AKI in patients with no-reflow phenomenon following PCI. Probability tables and Pearson chi-square tests were used for univariate analysis.

Results:

Among a population of 3034 patients, 93 (3%) were diagnosed as having coronary no-reflow (64% male, the mean age of 64±12 years). CI-AKI occurred in 22% of the patients with coronary no-reflow (n=20). The univariate analysis has demonstrated significant associations of post PCI TIMI flow 0-1 and pulmonary arterial hypertension (PHT) with the evolution of CI-AKI in the setting of the no-reflow phenomenon.

Conclusions:

In CAD patients managed with PCI, PHT, post PCI TIMI flow as well as an existing coronary ectasia pose a significant risk for the evolution of CI-AKI irrespective of LVEF values in subjects with the coronary no-reflow phenomenon.

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