Introduction:
Coronary Angiography (CAG) is an integral diagnostic and therapeutic strategy in the management of patients with coronary artery disease, especially those presenting with acute coronary syndromes. The procedure carries a risk of Contrast-Associated Acute Kidney Injury (CA-AKI) defined as a rise in serum creatinine within 48 hours post-CAG, and has a variable incidence and can be associated with serious complications. This study investigates the incidence and predictors of CA-AKI in the Omani population. The study provides a unique opportunity to examine this entity in a population with high incidence of diabetes and extensive coronary and non-coronary atherosclerosis. We aim to validate the previously described risk factors and explore potential additional risk factors specific to this group.
Methods:
This is a retrospective, single-center, cohort study of patients >18 years of age at Sultan Qaboos University Hospital undergoing Coronary Angiography of various indications. Consecutive patients were enrolled from the Catheterization Laboratory Registry between August 2020 to June 2022.
Results:
Out of 369 included patients, 48 (13%) developed CA-AKI and out of those 8 (2.2%) patients required renal replacement therapy. In multivariate logistic regression analysis, Pulmonary Edema (OR 10.9, include 95% confidence interval, p value < 0.05), peri-procedural hypotension (OR 1.316, include 95% confidence interval, p value < 0.05), Pre-procedure serum albumin (OR 1.316, include 95% confidence interval, p value 0.05) were the only independent risk factors. The results of a receiver-operating curve analysis indicated a serum albumin level of 40 g/L was the optimal cut-off value for prediction of contrast-associated acute kidney injury.
Conclusions:
The incidence of CA-AKI in Omani population was similar to the published literature. Pulmonary Edema and peri-procedural hypotension are recognized risk factors, but serum albumin level was only recently published. Early recognition of those patients undergoing CAG warrants better preventive measures and more close observation of renal parameters deterioration. Careful consideration of the risk factors described in our analysis is warranted in order not to deny a much required procedure, especially when our analysis did not show an association between CA-AKI and contrast exposure which is consistent with the current perspective on whether exposure to iodinated contrast does actually cause CA-AKI.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.