NT-proBNP as a Predictive Biomarker for Contrast-Induced Nephropathy in ACS Patients Undergoing Coronary Angiogram – An Observational Study

Abstract

1. To assess the value of baseline NTproBNP at admission and to determine the levels of serum creatinine at 48 hours and 72 hours after procedure for evidence of contrast-induced nephropathy (CIN) for patients undergoing CAG. 2. To evaluate the relationship between the values of NTproBNP and evidence of CIN. This is an observational study performed between June 2021-November 2021 at Nizams Institute of Medical Sciences in 75 patients diagnosed with ACS. we assessed the role of nt pro bnp as a predictive biomarker for diagnosis of contrast induced nephropathy in patients of ACS undergoing coronary angiography. Serum creatinine is repeated at 48 h post procedure and compared to baseline. Spearman’s correlation test was used to assess the correlation between NT-proBNP values and ejection fraction on the 2D echo. The rho value (-0.69) was suggestive of a strong negative correlation. P value & lt; 0.001 making it statistically significant. Simple linear regression analysis was used to predict the NT-proBNP levels by ejection fraction percentage among study patients, it showed that, for every 1% decrease in ejection fraction, the NT-proBNP levels will significantly increase by 102.90 pg/mL at P and lt; 0.001. Wilcoxon Signed Rank test was used to compare the baseline serum creatinine values with 48/72 h serum creatinine values after undergoing angiography with contrast, incidence of acute kidney injury (AKI) as shown by the resulting P value was and lt; 0.001, thus statistically significant. The ROC curve analysis to establish the association between NT-proBNP as a marker for incidence of AKI (CIN) shows shows that, NT-proBNP cut off and gt;1670 pg/mL has a sensitivity of 81.82% and specifity of 98.44% and is statistically significant with P value and lt; 0.001. It was observed that NT-proBNP >1670 pg/mL prior to the procedure, was significantly associated with the risk of development of contrast induced nephropathy. Measurement of serum NT-proBNP pre procedure aids in identifying at risk population for developing CIN.