We investigated the relationship between atrial fibrillation (AF) and contrast-induced nephropathy (CIN) in patients with non-ST-segment elevation myocardial infarction (NSTEMI); 1045 consecutive patients undergoing percutaneous coronary interventions were enrolled. Risk factors for CIN were investigated. Baseline characteristics, except oral anticoagulant use, were similar between patients with and without AF. Patients with CIN show higher presence of diabetes mellitus (DM), coronary artery bypass graft surgery history, Mehran score, baseline creatinine levels, baseline glomerular filtration rate (GFR), peak troponin levels, left ventricular ejection fraction (LVEF), and presence of AF (P < .05). In multivariate logistic regression analyses, the presence of DM (odds ratio [OR], 2.333; 95% confidence interval [CI], 1.222-4.457; P = .010), Mehran score (OR, 1.269; 95% CI, 1.152-1.398; P < .001), baseline GFR (OR, 0,954; 95% CI, 0.944-0.964 P < .001), left anterior descending artery originated infarction (OR, 1.594; 95% CI, 1.061-2.398; P = .025), LVEF value (OR, 0.956; 95% CI, 0.926-0.986; P = .005), and the presence of AF (OR, 3.830; 95% CI, 1.239-11.839; P = .020) were independent predictors of CIN. Atrial fibrillation can be related to CIN development in patients with NSTEMI.
ColillaSCrowAPetkunWSingerDESimonTLiuX. Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population. Am J Cardiol. 2013;112(8):1142–1147.
2.
KralevSSchneiderKLangSSüselbeckTBorggrefeM. Incidence and severity of coronary artery disease in patients with atrial fibrillation undergoing first-time coronary angiography. PLoS One. 2011;6(9):249–264.
3.
LopesRDPieperKSHortonJR. Short-and long-term outcomes in patients following atrial fibrillation with acute coronary syndromes with or without ST-segment elevation. Heart. 2008;94(7):867–873.
4.
SchmittJDurayGGershBJHohnloserSH. Atrial fibrillation in acute myocardial infarction: a systematic review of the incidence, clinical features and prognostic implications. Eur Heart J. 2009;30(9):1038–1045.
5.
GoldenbergIMatetzkyS. Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. CMAJ. 2005;172(11):1461–1471.
6.
BestPJLennonRTingHH. The impact of renal insufficiency on clinical outcomes in patients undergoing percutaneous coronary interventions. J Am Coll Cardiol. 2002;39(7):1113–1139.
7.
McCulloughPAAdamABeckerCR; CIN Consensus Working Panel. Epidemiology and prognostic implications of contrast-induced nephropathy. Am J Cardiol. 2006;98(6A):5–13.
8.
WatanabeHWatanabeTSasakiSRodenDMAizawaY. Close bidirectional relationship between chronic kidney disease and atrial fibrillation: the Niigata preventive medicine study. Am Heart J. 2009;158(4):629–636.
9.
GoldenbergIMatetzkyS. Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. CMAJ. 2005;172(11):1461–1471.
10.
AndreucciMSolomonRTasanarongA. Side effects of radiographic contrast media: pathogenesis, risk factors, and prevention. Biomed Res Int. 2014;2014:1–20. doi:10.1155/2014/741018.
11.
BalliMTaşolarHÇetinM. Is atrial fibrillation a risk factor for contrast-induced nephropathy in patients with ST-elevation myocardial infarction?J Cardiol. 2016;67(4):327–330.
12.
HammCWBassandJPAgewallS; ESC Committee for Practice Guidelines. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Task Force for the Management of Acute Coronary Syndromes (ACS) in Patients Presenting Without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2011;32(23):2999–3054.
13.
Expert Panel on Detection Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285(19):2486–2497.
14.
JanuaryCTWannLSAlpertJS; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64(21):2246–2280.
15.
ThomsenHS. European Society of Urogenital Radiology (ESUR) guidelines on the safe use of iodinated contrast media. Eur J Radiol. 2006;60(3):307–313.
16.
LeveyASBergRLGassmanJJHallPMWalkerWG. Creatinine filtration, secretion and excretion during progressive renal disease. Modification of Diet in Renal Disease (MDRD) Study Group. Kidney Int Suppl. 1989;27:S73–S80.
17.
MehranRAymongEDNikolskyE. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol. 2004;44(7):1393–1399.
18.
TepelMAspelinPLameireN. Contrast-induced nephropathy: a clinical and evidence-based approach. Circulation. 2006;113(14):1799–1806.
19.
McCulloughPAWolynRRocherLLLevinRNO’NeillWW. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med. 1997;103(5):368–375.
20.
McCulloughPA. Contrast-induced acute kidney injury. J Am Coll Cardiol. 2008;51(15):1419–1428.
21.
GoldenbergIMatetzkyS. Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. CMAJ. 2005;172(11):1461–1471.
22.
UgurMUluganyanMEkmekciA. Combination of hemoglobin and left ventricular ejection fraction as a new predictor of contrast induced nephropathy in patients with non-ST elevation myocardial infarction. Med Sci Monit. 2014;20(12):967–973.
23.
TsangTSMiyasakaYBarnesMEGershBJ. Epidemiological profile of atrial fibrillation: a contemporary perspective. Prog Cardiovasc Dis. 2005;48(1):1–8.
24.
GiglioliCMinelliMChiostriM. Prognostic impact of atrial fibrillation occurrence in patients with non-ST-elevation acute coronary syndromes: is dysrhythmia duration a parameter to focus on?Intern Emerg Med. 2014;9(5):521–528.
25.
ChungMKMartinDOSprecherD. C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation. 2001;104(24):2886–2891.
26.
LandrayMJWheelerDCLipGY. Inflammation, endothelial dysfunction, and platelet activation in patients with chronic kidney disease: the Chronic Renal Impairment in Birmingham (CRIB) study. Am J Kidney Dis. 2004;43(2):244–253.
27.
BursteinBQiXYYehYHCalderoneANattelS. Atrial cardiomyocyte tachycardia alters cardiac fibroblast function: a novel consideration in atrial remodeling. Cardiovasc Res. 2007;76(3):442–452.
28.
GoetteAStaackTRöckenC. Increased expression of extracellular signal-regulated kinase and angiotensin-converting enzyme in human atria during atrial fibrillation. J Am Coll Cardiol. 2000;35(6):1669–1677.
29.
NaitoMDavidDMichelsonELSchaffenburgMDreifusLS. The hemodynamic consequences of cardiac arrhythmias: evaluation of the relative roles of abnormal atrioventricular sequencing, irregularity of ventricular rhythm and atrial fibrillation in a canine model. Am Heart J. 1983;106(2):284–291.
