Polymorbidity factor in the development of contrastinduced nephropathy in patients with acute myocardial infarction who underwent coronary angiography and percutaneous coronary intervention

Aim. To estimate the importance of polymorbidity factor in the development of contrast-induced nephropathy in patients with acute myocardial infarction who underwent computed tomography (CT) coronarography and percutaneous coronary intervention (PCI).Material and Methods. We carried out the retrospective analysis of clinical cases of patients with acute myocardial infarction who underwent CT coronarography and PCI in N. S. Karpovich Emergency Hospital of Krasnoyarsk city in 2015. The sample consisted of 33 patients with a clinical verified diagnosis of contrast-induced nephropathy. We used the “R” and “G*Power” software for the statistical analysis of our data. Nonparametric methods of data analyses, such as analysis of variance of repeated measures and Mann-Whitney U-test were used. We also used the two-factor analysis of variance after logarithmicdata transformation. Data are presented as median and 25% and 75% quartiles.Results. Among 33 sampled patients with diagnosed contrast-induced nephropathy, 15 patients were females and 13 patients were males. The mean age was 70.9 ± 11.5 years. We divided this sample into polymorbidity and non-polymorbidity groups. The mean creatinine level in polymorbidity patients was 127 μmol/L (95; 179). Non-polymorbidity patients had a creatinine level of 130 μmol/L (91; 179). We did not detect any significant impact of polymorbidity factor on the temporal changes in the creatinine level (p > 0.05) in patients with contrast-induced nephropathy. Paired comparison based on both logarithmic transformation data using T-test and non-transformed values using Mann - Whitney U test did not show any significant differences between the creatinine levels in polymorbidity and non-polymorbidity patients. The absence of a strong correlation between creatinine levels and polymorbidity at chosen time intervals in the presence of significantly increasing creatinine values may be explained by the influence of other factors. In our case, we attribute an impact of contrast medium on kidney filtration. Their high variability explains the asymmetric distribution of creatinine values both in the entire sample and in the subgroups. The polymorbidity factor should not require special attention in regard to patients with acute myocardial infarction who need emergency CT coronarography and life-saving PCI.Conclusion. The polymorbidity factor did not significantly affect the development of contrast-induced nephropathy in patients with acute myocardial infarction undergoing CT coronarography and PCI.