Predictors of Contrast-induced Acute Renal Injury in Patients With Acute Coronary Syndrome

This prospective observational study investigates predictors of contrast-induced acute kidney injury (CI-AKI) among patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). The study was conducted from November 2024 to June 2025 at a tertiary cardiac center.

Patients with ACS who underwent coronary angiography or PCI were enrolled consecutively. Clinical characteristics, laboratory parameters, hydration status, use of nephrotoxic drugs, and type and volume of contrast media were recorded. Serum creatinine levels were measured before and 48-72 hours after contrast exposure, and CI-AKI was defined according to KDIGO criteria.

The primary objective is to identify independent predictors of CI-AKI using multivariate analysis. Secondary objectives include evaluation of short-term outcomes, such as in-hospital complications and renal function recovery at 90 days. The results are expected to improve understanding of CI-AKI risk in real-world ACS patients and to support preventive strategies in interventional cardiology.

Inclusion criteria

Age ≥ 18 years

Diagnosis of acute coronary syndrome (STEMI or NSTEMI) confirmed by clinical, ECG, and laboratory findings

Undergoing coronary angiography or percutaneous coronary intervention with intravascular contrast administration

Provided informed consent to participate in the study

Availability of baseline and follow-up serum creatinine values

Exclusion criteria

Known chronic kidney disease stage 4 or 5 (eGFR < 30 mL/min/1.73 m²) or on dialysis

Hemodynamic instability not related to acute coronary syndrome (e.g., septic shock)

Exposure to intravenous contrast within the previous 7 days

Use of nephrotoxic drugs (e.g., aminoglycosides, amphotericin B) within 72 hours prior to contrast exposure

Active infection or inflammatory disease affecting renal function

Pregnancy or breastfeeding

Refusal or inability to provide informed consent