Detection of Contrast Induced Nephropathy Undergoing Percutaneous Coronary Intervention among Patients with Acute Coronary Syndrome

Q: What are the key findings of this study?

Pre-procedural microalbuminuria was associated with a higher incidence of contrast-induced nephropathy after PCI compared to normoalbuminuria.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Acute coronary syndrome undergoing percutaneous coronary intervention (n=164). Intervention: Pre-procedural microalbuminuria (urinary albumin-to-creatinine ratio 30–300 mg/g) vs. Pre-procedural normoalbuminuria (urinary albumin-to-creatinine ratio <30 mg/g). Primary outcome: Contrast-induced nephropathy (≥25% relative increase or ≥0.5 mg/dL absolute increase in serum creatinine within 48–72 hours after contrast exposure) (ARR 20.3%, p=0.003).

Azfar Hossain Bhuiyan; Md Abdullah Yusuf; Md. Rashed Reza; KAM Mahbub Hasan; Mohammad Fakhruzzaman; Mohammad Mahmudur Rahman‬; Noshin Tabassum; Mohammad Kamrul Hasan; Tanvir Adnan

doi:10.3329/jninb.v12i1.94391

November 8, 2026Journal of National Institute of Neurosciences BangladeshOpen Access

Detection of Contrast Induced Nephropathy Undergoing Percutaneous Coronary Intervention among Patients with Acute Coronary Syndrome

View Full Paper

Ask AI

Bookmark

Share

Key result

Pre-procedural microalbuminuria is linked to ~20-point higher contrast-induced nephropathy risk after PCI.

ARR 20.3%
P=0.003
n=164

Why the study?

Contrast-induced nephropathy is a clinically important complication following PCI in patients with ACS, and early detection using urinary albumin-to-creatinine ratio may facilitate timely identification of patients at increased risk.

Does pre-procedural microalbuminuria predict the development of contrast-induced nephropathy in patients with acute coronary syndrome undergoing percutaneous coronary intervention?

Key Points

To determine whether pre-procedural urinary albumin-to-creatinine ratio can detect and predict the development of contrast-induced nephropathy in patients with acute coronary syndrome undergoing percutaneous coronary intervention.
Conducted a cross-sectional study enrolling 164 consecutive patients with acute coronary syndrome undergoing percutaneous coronary intervention at a single center.
Categorized participants based on pre-procedural urinary albumin-to-creatinine ratio into microalbuminuria (30–300 mg/g; n=67) and normoalbuminuria (<30 mg/g; n=97) groups.
Assessed renal function via serum creatinine before the procedure and at 48 hours following iodinated contrast media exposure to identify contrast-induced nephropathy.
Contrast-induced nephropathy developed in 39 patients (23.8%) overall, with a significantly higher incidence in the microalbuminuria group than in the normoalbuminuria group (35.8% vs. 15.5%; p=0.003).
Baseline serum creatinine levels were comparable between the microalbuminuria and normoalbuminuria groups (1.17 ± 0.14 vs. 1.15 ± 0.14 mg/dL; p=0.376).
At 48 hours after percutaneous coronary intervention, serum creatinine was significantly higher in the microalbuminuria group compared with the normoalbuminuria group (1.46 ± 0.33 vs. 1.28 ± 0.30 mg/dL; p=0.001).

Study Design

Type

Cross-Sectional (n=164)

Multicenter

No

Structured PICO

Does pre-procedural microalbuminuria predict the development of contrast-induced nephropathy in patients with acute coronary syndrome undergoing percutaneous coronary intervention?

P

Population

164 adults with acute coronary syndrome undergoing percutaneous coronary intervention at a single center in Bangladesh, free of pre-existing kidney disease, macroalbuminuria, or hemodynamic instability, followed for 48–72 hours post-procedure.

E

Exposure

Pre-procedural microalbuminuria (Group I: urinary albumin-to-creatinine ratio [uACR] 30-300 mg/g) prior to coronary angiography and percutaneous coronary intervention (PCI) using iodinated contrast media.

C

Comparator

Pre-procedural normoalbuminuria (Group II: urinary albumin-to-creatinine ratio [uACR] <30 mg/g) prior to coronary angiography and percutaneous coronary intervention (PCI) using iodinated contrast media.

O

Outcome

Development of contrast-induced nephropathy (CIN) within 48-72 hours after contrast exposure, defined as a >=25% relative increase in serum creatinine or an absolute increase of >=0.5 mg/dL (44 umol/L) from baseline in the absence of an alternative explanation.safety

Main Result

Absolute Risk Reduction: 20.3

Absolute Event Rate: 35.8% vs 15.5%

Absolute Risk Reduction: 20.3%

p-value: p=0.003

Limitations

Single tertiary cardiac center study
Relatively modest sample size of 164 patients
Observational cross-sectional design limits conclusions regarding causality
Lack of multivariable adjustment for potential confounders such as contrast volume, diabetes, anemia, heart failure severity, eGFR, and medications

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Pre-procedural microalbuminuria is significantly associated with more than double the risk of developing contrast-induced nephropathy in acute coronary syndrome patients undergoing PCI despite comparable baseline serum creatinine levels.

Abstract

Background: Contrast-induced nephropathy (CIN) is a clinically important complication following percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS), and early detection using urinary albumin-to-creatinine ratio (uACR) may facilitate timely identification of patients at increased risk. Objective: The purpose of this present study was to detect contrast-induced nephropathy by urinary ACR undergoing percutaneous coronary intervention among patients with acute coronary syndrome Methodology: This cross-sectional study was conducted in the Department of Cardiology at National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh, from August 2021 to July 2023. Consecutive patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) were enrolled and were categorized into two groups according to urinary albumin excretion status: Group A, with microalbuminuria, and Group B, with normoalbuminuria. The association between pre-procedural microalbuminuria and the subsequent development of contrast-induced nephropathy (CIN) was evaluated using receiver operating characteristic (ROC) curve analysis. Results: A total of 164 patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI) were included. Of these, 67 (40.9%) had microalbuminuria (Group I), while 97 (59.1%) had normoalbuminuria (Group II). The mean age was 55.53 ± 11.66 years in Group I and 54.38 ± 10.71 years in Group II, with no significant difference (p=0.514). Age distribution was also comparable between the groups (p=0.762). The mean urinary albumin-to-creatinine ratio (uACR) was higher in Group I than in Group II (73.75 ± 5.60 vs. 16.24 ± 6.43 mg/g). Baseline serum creatinine levels were comparable between the groups (1.17 ± 0.14 vs. 1.15 ± 0.14 mg/dL; p=0.376). However, 48 hours after PCI, serum creatinine was significantly higher in Group I than in Group II (1.46 ± 0.33 vs. 1.28 ± 0.30 mg/dL; p=0.001). Contrast-induced nephropathy (CIN) developed in 39 patients (23.8%). The incidence was significantly higher in Group I than in Group II (35.8% vs. 15.5%; p=0.003). These findings indicate a significant association between pre-procedural microalbuminuria and an increased risk of CIN following PCI. Conclusion: Pre-procedure microalbuminuria is an important biochemical parameter for prediction development of CIN among patients with ACS undergoing PCI. Journal of National Institute of Neurosciences Bangladesh, January 2026;12(1):101-109

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Bhuiyan et al. (2026) conducted a cross-sectional in Acute coronary syndrome undergoing percutaneous coronary intervention (n=164). Pre-procedural microalbuminuria (urinary albumin-to-creatinine ratio 30–300 mg/g) vs. Pre-procedural normoalbuminuria (urinary albumin-to-creatinine ratio <30 mg/g) was evaluated on Contrast-induced nephropathy (≥25% relative increase or ≥0.5 mg/dL absolute increase in serum creatinine within 48–72 hours after contrast exposure) (ARR 20.3%, p=0.003). Pre-procedural microalbuminuria was associated with a higher incidence of contrast-induced nephropathy after PCI compared to normoalbuminuria.

synapsesocial.com/papers/6af1d893f9a8addd138b1c8b https://doi.org/10.3329/jninb.v12i1.94391

View Full Paper

Ask AI

Bookmark

Share

Detection of Contrast Induced Nephropathy Undergoing Percutaneous Coronary Intervention among Patients with Acute Coronary Syndrome

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Detection of Contrast Induced Nephropathy Undergoing Percutaneous Coronary Intervention among Patients with Acute Coronary Syndrome

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading