The Predictive Value of H2FPEF Score for Contrast Induced Nephropathy in NSTEMI Patients Undergoing Emergency PCI

International Journal of the Cardiovascular Academy · Published 2025-09-15 · DOI 10.4274/ijca.2025.78300

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Abstract

Background and Aim: Contrast-induced nephropathy (CIN) is acute kidney damage that occurs after recent radiographic contrast media exposure. The aim of our study was to evaluate the association of H2FPEF score with CIN in patients with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing emergency coronary angiography and percutaneous coronary intervention (PCI). Materials and Methods: This prospective single center study included 600 patients with NSTEMI scheduled for both emergency coronary angiography and PCI. They were classified into 2 groups according to the incidence of CIN: the first group included 89 patients who developed CIN, and the second group included 511 patients without CIN. All studied cases were clinically evaluated. Echocardiographic assessment, coronary angiography and PCI were done. Results: Age, hypertension, diabetes mellitus (DM), presence of heart failure and atrial fibrillation, pulmonary artery systolic pressure and H2FPEF were found to be significant predictors of CIN after emergency PCI. Multivariate logistic regression analysis detected age, DM, and H2FPEF as the only significant predictors of CIN after emergency PCI. H2FPEF score can predict CIN with AUC of 0.575 and P-value of 0.020, at cutoff >1, with 85.39% sensitivity, 50.49% specificity, 16.1% positive predictive value and 89.8% negative predictive value. Conclusion: H2FPEF score shows a statistically significant but limited discriminatory ability in predicting CIN. Its utility as a standalone predictor appears limited and requires further validation.

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Publication details

Year
2025

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