Turk Kardiyol Dern Ars. 2015; 43(7): 613-620 | DOI: 10.5543/tkda.2015.37941

Relationship between red cell distribution width and contrast-induced nephropathy in patients who underwent primary percutaneous coronary intervention

Dursun Çayan Akkoyun¹, Aydın Akyüz¹, Ömer Kurt², Bülent Bilir³, Şeref Alpsoy¹, Niyazi Güler^1
1Department of Cardiology, Namik Kemal University Faculty of Medicine, Tekirdag,turkey
²Department of Urology, Namik Kemal University Faculty of Medicine, Tekirdag,turkey
³Department of Internal Medicine, Namik Kemal University Faculty of Medicine, Tekirdag,turkey

OBJECTIVE
This study evaluated the relationship between contrast-induced nephropathy (CIN) and red cell distribution width (RDW) in patients who underwent primary percutaneous coronary intervention (PCI).

METHODS
A total of 359 patients with ST elevation myocardial infarction (STEMI) who had undergone primary PCI were included in the study. An increase of 25% in serum creatinine value after 48 h, or an increase of >0.5 mg/dL in the basal value was defined as CIN.

RESULTS
Of the patients included in the study, 49 (13.8%) developed CIN. Compared to the CIN-negative group, CINpositive patients had increased RDW values (16.9±2.00 and 14.8±2.14 respectively, p<0.001). The latter were also older patients, and had increased age rates of diabetes mellitus, baseline creatinine, Δ-creatinine and amount of contrast media were higher and left ventricular ejection fraction and baseline glomerular filtration rate (GFR) were lower in the CIN-positive group than in the CIN-negative group. A statistically weak correlation was found between RDW and change in creatinine levels (Δ-creatinine) (r=0.250, p=0.002). Diabetes mellitus (odds ratio [OR]: 3.252, 95% CI=1.184-8.951, p=0.022), high RDW (OR: 1.716, 95% CI=1.363–2.157, p<0.001), baseline low GFR (OR: 0.941, 95% CI=0.925– 0.971, p<0.001), Δ-creatinine (OR: 1.197, 95% CI=1.061- 2.986, p=0.006) and increased amount of contrast media (OR: 1.187, 95% CI=1.048–3.02, p=0.001) used were observed as independent predictors of CIN.

CONCLUSION
The study found diabetes mellitus, high RDW, basal low GFR, Δ-creatinine and increased contrast amount used to be the independent predictors of CIN in STEMI patients who underwent PCI.

Keywords: Angioplasty, balloon, coronary, contrast media; contrast induced nephropathy; myocardial infarction; percutaneous transluminal coronary angioplasty; red cell distribution width

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