ASSOCIATION BETWEEN ADMISSION MEAN ARTERIAL PRESSURE AND THE DEVELOPMENT OF CONTRAST-ASSOCIATED ACUTE KIDNEY INJURY WITHIN THE FIRST 72 HOURS IN PATIENTS WITH NSTEMI

Introduction: Contrast-associated acute kidney injury (CI-AKI) is a frequent and clinically important complication after percutaneous coronary intervention (PCI), particularly in hemodynamically unstable patients with non–ST-elevation myocardial infarction (NSTEMI). Mean arterial pressure (MAP) is a key determinant of renal perfusion, yet the impact of admission MAP on CI-AKI development in NSTEMI patients undergoing PCI has not been clearly established. To investigate the relationship between admission MAP and the development of CI-AKI within the first 72 hours after PCI in patients with NSTEMI. Methods: This single-center, retrospective observational study included 150 consecutive patients hospitalized with NSTEMI who underwent PCI between January and December 2025. Admission systolic and diastolic blood pressures were obtained from emergency department triage records and MAP was calculated using the standard formula (MAP = [SBP + 2×DBP]/3). CI-AKI was defined according to KDIGO criteria as an increase in serum creatinine ≥0.3 mg/dL or ≥50% from baseline within 72 hours after contrast exposure. Patients were divided into two groups: those who developed CI-AKI (n=62, 41.3%) and those who did not (n=88, 58.7%). Non-parametric tests and Spearman correlation analysis were used. Results: The overall mean MAP was 88.99±27.44 mmHg. Patients who developed CI-AKI had significantly lower admission MAP compared with those without CI-AKI (60.33±3.95 vs. 109.18±16.76 mmHg; p<0.001). Lower MAP was positively correlated with body mass index and heart rate. Chronic kidney disease and hyperlipidemia were more frequent among patients with CI-AKI and were also associated with lower MAP values (both p<0.001). Conclusion: In NSTEMI patients undergoing PCI, lower admission MAP is strongly associated with the development of CI-AKI within 72 hours. Given that MAP is a simple, rapid, and noninvasive parameter, its routine assessment at presentation may help identify high-risk patients and support clinical awareness regarding preventive care.