DOI: https://doi.org/10.53350/pjmhs221651467 ORIGINAL ARTICLE P J M H S Vol. 16, No. 05, May 2022 1467 Contrast-Induced Nephropathy Factors and Prevalence in Patients Getting Multi-Vessel Percutaneous Coronary Intervention BAKHT UMAR KHAN 1 , FAHAD KHALID 2 , OMER AZIZ MIRZA 3 , FAYAZ AHMED MEMON 4 , MUHAMMAD SHAHID 5 , MUHAMMAD SHEHRAM 6 1 Medical Officer, Type-D Hospital Baffa, Distt. Mansehra, KPK. 2 Registrar Deptt of Cardiology, FGPC (Federal Govt Polyclinic Hospital) Islamabad 3 Consultant Cardiologist / Senior Registrar Deptt of Cardiology, Abbotabad International medical college Abbotabad, Pakistan 4 Professor Department of Medicine, Muhammed Medical College & Hospital, Mirpurkhas, Sindh. 5 Head of Department, Associate Professor of Cardiology, DHQ/Teaching Hospital, Gujranwala Medical College Gujranwala 6 MBBS, FCPS Cardiology. District Specialist, Paharpur Hospital, D. I. Khan. Corresponding author: Bakht Umar Khan, Email: drbakhtumar@gmail.com, Cell: +923005335664 ABSTRACT Objective: To assess the prevalence of contrast-induced nephropathy and its associated risk factors in patients undergoing multi-vessel percutaneous coronary intervention (PCI). Study Design: Observational/ Prospective study Place and Duration: Armed forces institute of cardiology & National Institute of heart diseases, Rawalpindi, during from the period September 2019 to Feb 2020. Methods: There were 112 patients of both genders with ages 18-75 years were presented in this study. Data on enrolled patients' age, gender, BMI, marital status and education level were collected after receiving written permission from each patient. This research included people who had undergone a percutaneous coronary intervention. Serum creatinine >0.5mg/dl from the baseline value was classified as contrast induced nephropathy. CIN-related risk factors were studied. Data was analyzed using SPSS 24.0. Results: The mean age of the patients was 51.6±9.53 years and had mean BMI 23.5±15.67 kg/m 2 . Majority were males 68 (60.7%) and 44 (39.3%) were females. There were 75 (66.96%) patients married and 55 (49.1%) patients were educated. Frequency of contrast induced nephropathy was among 25 (22.3%) cases. Most common risk factor of CIP was contrast volume 19 (76%) and hypertension found in 17 (68%) cases, followed by diabetes mellitus in 15 (60%) cases, age >65 years in 13 (52%) cases, CHF in 11 (44%) cases, smoking history in 9 (36%) cases and family history of CAD was 4 (16%). Conclusion: Patients undergoing PCI are at a considerable risk of developing contrast-induced nephropathy. Among the risk variables for CIN were anaemia (age >70 years), diabetes mellitus (contrast volume >150 ml), and heart failure. Keywords: Risk Factors, Contrast Induced Nephropathy, Percutaneous Coronary Intervention INTRODUCTION Patients with ST-segment elevation myocardial infarction should have primary percutaneous coronary intervention (PCI) as their preferred method of reperfusion (STEMI). Compared to thrombolysis, it has a lower mortality and morbidity rate when administered during the first 12 hours following the start of symptoms [1]. When contrast media is used during surgery, it is possible that the patient will develop contrast-induced nephropathy (CIN), which reduces their glomerular filtration rate. CIN is associated with a higher mortality and morbidity rate, as well as an increased use of healthcare resources and an increase in the cost of care [2]. Between 10% and 23% of patients who underwent initial PCI developed CIN, according to recent studies. CIN has been linked to an increased risk of death in the hospital following primary PCI by a factor of four to eight [3-5]. Despite the widespread use of contrast agents in diagnostic imaging and interventional procedures [3,6], it is still unclear how CIN develops, but different processes like oxidative stress, vasoconstriction and medullary ischemia as well as allergic responses to contrast media have all been implicated [3,6]. Acute kidney damage (AKI) is more likely in patients with chronic renal disease, diabetes, hemodynamic abnormalities and volume depletion as a consequence of cardiogenic shock or heart failure, advanced interventional procedures, and the administration of extra contrast dye during treatment [7]. However, conflicting findings have been found in several meta-analyses and large trials [8, 9] regarding the benefits of two- stage multivessel revascularization in AMI compared to immediate complicated angioplasty [10]. Contrast burden, which tends to be larger in sophisticated multivessel procedures, is a major factor in developing CIN [11]. Additionally, post-procedural CIN patients have a higher risk of short- and long-term cardiac complications [11, 12]. In order to minimize CIN incidence and enhance outcomes, it is critical to identify AMI patients who are at high risk of CIN early in the course of their treatment. CIN's aetiology, on the other hand, remains a mystery. CIN is still untreatable in today's day and age. Perioperative preventions include intravenous hydration before and after surgery, lowering contrast doses, and the use of low- or iso-osmolar contrast medium, all of which have been developed by researchers [13]. There is yet no conclusive evidence on the effectiveness of hydration and Western pharmacological therapies on the prevention of CIN. Traditional Chinese medicine may give a supplemental therapy for CIN because of Western medicine's limitations. Experiments in the past have shown that the oxidative stress response, which plays a crucial part in CIN formation, was reduced by Xuefu Zhuyu decoction, although the specific processes of CIN have not been fully understood.[14,15] Among patients undergoing multi-vessel percutaneous coronary intervention, this study seeks to determine the frequency of contrast-induced nephropathy and the risk factors that may contribute to its development (PCI). MATERIAL AND METHODS This Observational/ Prospective study was conducted at Armed forces institute of cardiology & National Institute of heart diseases, Rawalpindi, during from the period September 2019 to Feb 2020 and comprised of 112 patients. Data on the ages, genders, weights, and marital statuses of patients were only obtained with their express written consent. In this trial, patients under the age of 18, those with pre-existing renal impairment, and those who refused to take part were excluded. Consenting patients who met the study's eligibility requirements were enrolled one at a time. Participants had to be either male or female, aged 18 to 75, and have a normal baseline serum creatinine level (1.2 mg/dL. Shock or Killip class IV or CKD or end-stage renal disease patients were not included in the study. All of the patients' medical records were collected and catalogued in this manner. There was a history of chest pain lasting more than half an hour and an ST-segment elevation at baseline on the baseline ECG used to make the STEMI diagnosis.