Preprocedural N-Terminal pro-brain natriuretic peptide (NT-proBNP) is similar to the mehran contrast-induced nephropathy (CIN) score in predicting CIN following elective coronary angiography

Background-n-terminal pro-brain natriuretic peptide (nt-probnp) has been associated with important risk factors for contrastinduced nephropathy (cin). however,few studies have investigated the predictive value of nt-probnp itself. this study investigated whether levels of preprocedural nt-probnp could predict cin after elective coronary angiography as effectively as the mehran cin score. methods and results-we retrospectively observed 2248 patients who underwent elective coronary angiography. the predictive value of preprocedural nt-probnp for cin was assessed by receiver operating characteristic and multivariable logistic regression analysis. the 50 patients (2.2%) who developed cin had higher mehran risk scores (9.5±5.1 versus 4.8±3.8),and higher preprocedural levels of nt-probnp (5320±7423 versus 1078±2548 pg/ml,p<0.001). receiver operating characteristic analysis revealed that nt-probnp was not significantly different from the mehran cin score in predicting cin (c=0.7657 versus c=0.7729,p=0.8431). an nt-probnp cutoff value of 682 pg/ml predicted cin with 78% sensitivity and 70% specificity. multivariable analysis suggested that,after adjustment for other risk factors,nt-probnp >682 pg/ml was significantly associated with cin (odds ratio: 4.007,95% ci: 1.950 to 8.234; p<0.001) and risk of death (hazard ratio: 2.53; 95% ci: 1.49 to 4.30; p=0.0006). conclusions-preprocedural nt-probnp >682 pg/ml was significantly associated with the risk of cin and death. nt-probnp,like the mehran cin score,may be another useful and rapid screening tool for cin and death risk assessment,identifying subjects who need therapeutic measures to prevent cin. © 2015 the authors. published on behalf of the american heart association,inc.