R2CHADS2 Score: An Effective Risk Stratification Tool for Contrast-Induced Nephropathy and Cardiovascular Outcomes in STEMI Patients Undergoing PCI.

Abstract

Contrast-induced nephropathy (CIN) is a serious complication following percutaneous coronary intervention (PCI). The Renal dysfunction, Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus and prior Stroke R2CHADS2 score, originally developed for thromboembolic risk assessment, has recently been proposed as a predictor of CIN and major adverse cardiovascular events (MACE). The present study aimed to evaluate the predictive value of the R2CHADS2 score for CIN and long-term MACE in STEMI patients undergoing primary PCI (pPCI). A total of 1204 STEMI patients were included in this retrospective study. Patients were categorized into 3 risk groups based on their R2CHADS2 scores. CIN incidence was significantly higher in the high-risk group (37.1%) compared with the moderate (13.6%) and low-risk groups (5.5%; P < .001). Hemodialysis was required in 14.3% of high-risk patients (P < .001). MACE occurred in 49.3% of the high-risk group, 22.1% of the moderate-risk group, and 12.9% of the low-risk group (P < .001). These findings suggest that the R2CHADS2 score can predict CIN and adverse cardiovascular outcomes in STEMI patients undergoing pPCI.