Preprocedural High-Sensitivity C-Reactive Protein Predicts Contrast-Induced Nephropathy and Long-Term Outcome After Coronary Angiography

Angiology. 2017 Aug;68(7):614-620. doi: 10.1177/0003319716674623. Epub 2016 Oct 25.

Abstract

We investigated whether high-sensitivity C-reactive protein (hsCRP) levels were associated with contrast-induced nephropathy (CIN) and long-term mortality after coronary angiography (CAG). Patients (N = 2133) undergoing CAG with preprocedural hsCRP were consecutively enrolled. High-sensitivity C-reactive protein was measured before angiography. Median follow-up was 2.3 years. The overall incidence of CIN was 2.77% (59 of 2133). There was a positive trend of hsCRP quartiles (Q) with rates of CIN: 0.9% for Q1 (<1.6 mg/L), 0.9% for Q2 (1.6-3.9 mg/L), 2.4% for Q3 (4.0-11.3mg/L), and 6.8% for Q4 (>11.3 mg/L; P < .05). The receiver operating characteristic (ROC) analysis showed that the cutoff point of hsCRP was 7.3 mg/L for predicting CIN with a 72.7% sensitivity and a 67.0% specificity (area under the curve [AUC] = 0.742, 95% confidence interval [CI] 0.672-0.810; P < .05). The predictive value of hsCRP was similar to the Mehran score for CIN (AUChsCRP = 0.742 vs AUCMehran = 0.801; P = .228). After adjustment for other potential risk factors, hsCRP >7.3 mg/L still was an independent predictor of CIN (odds ratio [OR] = 2.83, 95% CI: 1.44-5.58; P = .003). Furthermore, hsCRP >7.3 mg/L was associated with higher mortality (OR = 2.04, 95% CI: 1.30-3.19; P = .002).

Keywords: Mehran score; contrast-induced nephropathy; coronary angiography; high-sensitivity C-reactive protein; outcome.

MeSH terms

  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / adverse effects*
  • C-Reactive Protein / metabolism
  • Contrast Media / adverse effects
  • Coronary Angiography* / methods
  • Female
  • Humans
  • Kidney Diseases / diagnosis
  • Kidney Diseases / etiology*
  • Kidney Diseases / therapy*
  • Male
  • Middle Aged
  • ROC Curve
  • Risk Factors
  • Time

Substances

  • Contrast Media
  • C-Reactive Protein