The Association of Iodixanol With Renal and Cardiovascular Safety in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Prospective Cohort Study

Background: This study was performed to characterize the incidence, costs, and risk factors associated with renal and cardiovascular adverse outcomes following primary percutaneous coronary intervention (pPCI) in patients with ST-elevation myocardial infarction (STEMI).Methods: Patients with STEMI who underwent pPCI using iso-osmolar contrast were enrolled at 39 centers.The incidence of acute kidney injury (AKI) and major adverse renal and cardiovascular events (MARCE) was analyzed, as well as inpatient costs.Logistic regression analysis was performed to identify risk factors.Results: Among 2,293 patients, the incidence of AKI and MARCE within 72 hours post-pPCI was 4.14% (n = 95) and 4.40% (n = 101), respectively.AKI and/or MARCE were associated with systolic blood pressure (AKI: odds ratio [OR], 1.009; 95% confidence interval [CI], 1.000-1.018),hypertension (AKI: OR, 1.815; 95% CI, 1.133-2.906;MARCE: OR, 1.760; 95% CI, 1.118-2.769),anterior wall infarction (AKI: OR, 1.895; 95% CI, 1.196-3.004;MARCE: OR, 1.939; 95% CI, 1.240-3.032),Killip class (AKI: OR, 1.465; 95% CI, 1.117-1.922;MARCE: OR, 1.467; 95% CI, 1.131-1.903),and serum creatinine (SCr; MARCE: OR, 1.006; 95% CI, 1.000-1.012).Hospitalization costs for patients with STEMI who developed AKI or MARCE were significantly higher than for those without AKI (9,595 5,795 vs. 8,279 3,872 USD,