POINT OF CARE CREATININE MEASUREMENT IN URGENT PERCUTANEOUS CORONARY INTERVENTIONS TO PREDICT AND PREVENT CONTRAST INDUCED AKI: PRELIMINARY RESULTS

Introduction:

Percutaneous coronary intervention (PCI) is the common and frequently used as an urgent diagnostic and treatment procedures for the acute coronary syndrome (ACS) requiring radiographic contrast media. The development of contrast induced acute kidney injury (CI-AKI) may occurs in higher risk patients, especially with existing chronic kidney disease. In most of the cases of ACS, urgent actions need to perform PCI without knowing the baseline creatinine and/or waiting its results, thus the unwanted CI-AKI can be developed in risky patients. We aimed to use point of care creatinine measurements to calculate the baseline eGFR and to predict cases of preventable CI-AKI.

Methods:

A total of 63 patients with ACS were included in the study who needed urgent PCI. Point of care express creatinine measurements were conducted from finger capillary blood and compared to conventional biochemical panel creatinine values using Spearman’s correlation. The risk of CI-AKI development after PCI were calculated using the Mehran’s contrast nephropathy calculator. Post-PC developed CI-AKI is ascertained using KDIGO criteria.

Results:

General characteristics of study population presented in Figure 1. 

Among 63 patients, 39,7% were female and 60,3% were male, with average age of 63,1 years. 34 (54%) patients had post PCI creatinine values within the at least 7 days and among them 5 (14,7%) developed preventable CI-AKI. The predicted post PCI CI-AKI development by Mehran’s score were 20,6%, 8,8% and 5,9% for moderate, high and very high risks, respectively. Figure 2 shows significant linear correlation (r= 0.724, p value<0.0001) between express creatinine measured from capillary blood and biochemical panel creatinine. 

Conclusions:

Point of care creatinine measurements from finger capillary blood can provide baseline kidney function before urgent PCI and should be used to predict development of CI-AKI. Further studies in large cohorts and prescription of preventive infusions in moderate to high-risk patients’ during the urgent PCI warrants better outcomes after post PCI CI-AKI.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.