Original article Prevalence and Prognosis of Percutaneous Coronary Intervention- associated Nephropathy in Patients With Acute Coronary Syndrome and Normal Kidney Function Lorenzo Hernando,* Ester Canovas, Alfonso Freites, Adriana de la Rosa, Javier Alonso, Roberto del Castillo, Pablo Salinas, Gema Beatriz Montalvo, Ana Isabel Huelmos, and Javier Botas Servicio de Cardiologı´a, Hospital Universitario Fundacio ´n Alcorco ´n, Alcorco ´n, Madrid, Spain Rev Esp Cardiol. 2015;68(4):310–316 Article history: Received 11 December 2013 Accepted 2 April 2014 Available online 26 September 2014 Keywords: Kidney Acute coronary syndrome Percutaneous coronary intervention A B S T R A C T Introduction and objectives: The aim of this study was to analyze the prevalence, risk factors, and short- and long-term prognosis of patients with acute coronary syndrome and normal renal function who developed percutaneous coronary intervention-associated nephropathy. Methods: This was an observational, retrospective, single-center study with a prospective follow-up of 470 consecutive patients hospitalized for acute coronary syndrome (not in cardiogenic shock) who underwent percutaneous coronary intervention, with no preexisting renal failure (admission creatinine  1.3 mg/dL). Percutaneous coronary intervention-associated was defined as an increase in baseline creatinine  0.5 mg/dL or  25% baseline. The mean follow-up was 26.7 (14) months. Results: Of the 470 patients, 30 (6.4%) developed percutaneous coronary intervention-associated nepfhropathy. The independent predictors for acute renal failure were admission hemoglobin level (odds ratio = 0.71) and maximum troponin I level prior to the procedure (odds ratio = 1.02). During the long-term follow-up, the patients whose renal function deteriorated had a higher incidence of total mortality (5 [16.7%] vs 27 [6.1%]; P = .027). In the Cox regression analysis, percutaneous coronary intervention-associated nepfhropathy was not an independent predictor for total mortality, but could be a predictor for cardiac mortality (hazard ratio = 5.4; 95% confidence interval 1.35-21.3; P = .017). Conclusions: Percutaneous coronary intervention-associated nephropathy in patients with acute coronary syndrome and normal preexisting renal function is not uncommon and influences long- term survival. ß 2014 Sociedad Espan ˜ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L.U. All rights reserved. Prevalencia y prono ´ stico de la nefropatı´a tras intervencionismo coronario percuta ´ neo de pacientes con sı ´ndrome coronario agudo y funcio ´n renal normal Palabras clave: Rin ˜o ´n Sı ´ndrome coronario agudo Intervencionismo coronario percuta ´ neo R E S U M E N Introduccio ´n y objetivos: El objetivo de este estudio es analizar la prevalencia, los factores de riesgo y el prono ´ stico hospitalario y a largo plazo de los pacientes con sı ´ndrome coronario agudo y funcio ´n renal normal que presentan nefropatı ´a tras intervencionismo coronario percuta ´ neo. Me ´todos: Estudio observacional, retrospectivo y unice ´ ntrico con seguimiento prospectivo de 470 pacientes consecutivos ingresados por sı ´ndrome coronario agudo sin shock cardioge ´ nico y sometidos a intervencionismo coronario percuta ´ neo sin insuficiencia renal preexistente (creatinina al ingreso  1,3 mg/dl). La nefropatı ´a tras intervencionismo coronario percuta ´ neo se ha definido como un incremento de la creatinina basal  0,5 mg/dl o  25% del valor basal. La media de seguimiento fue 26,7  14 meses. Resultados: De los 470 pacientes, 30 (6,4%) presentaron nefropatı ´a tras intervencionismo coronario percuta ´ neo. Los factores independientes predictores de insuficiencia renal aguda fueron la hemoglobina al ingreso (odds ratio = 0,71) y la troponina I ma ´ xima previa al intervencionismo (odds ratio = 1,02). En el seguimiento a largo plazo, los pacientes cuya funcio ´n renal se deterioro ´ presentaron mayor incidencia de mortalidad total (5 [16,7%] frente a 27 [6,1%]; p = 0,027). En el ana ´ lisis de regresio ´n de Cox, la nefropatı ´a tras intervencionismo coronario percuta ´ neo no resulto ´ predictora independiente de la mortalidad total, pero podrı ´a ser predictora de la mortalidad cardiaca (hazard ratio = 5,4; intervalo de confianza del 95%, 1,35-21,3; p = 0,017). * Corresponding author: Servicio de Cardiologı ´a, Hospital Universitario Fundacio ´n Alcorco ´ n, Budapest 1, 28922 Alcorco ´ n, Madrid, Spain. E-mail address: lorenzo_hm@hotmail.com (L. Hernando). http://dx.doi.org/10.1016/j.rec.2014.04.016 1885-5857/ß 2014 Sociedad Espan ˜ ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L.U. All rights reserved. Document downloaded from http://www.revespcardiol.org, day 04/05/2015. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.