Detection of Contrast Induced Nephropathy Undergoing Percutaneous Coronary Intervention among Patients with Acute Coronary Syndrome

Background: Contrast-induced nephropathy (CIN) is a clinically important complication following percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS), and early detection using urinary albumin-to-creatinine ratio (uACR) may facilitate timely identification of patients at increased risk. Objective: The purpose of this present study was to detect contrast-induced nephropathy by urinary ACR undergoing percutaneous coronary intervention among patients with acute coronary syndrome Methodology: This cross-sectional study was conducted in the Department of Cardiology at National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh, from August 2021 to July 2023. Consecutive patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) were enrolled and were categorized into two groups according to urinary albumin excretion status: Group A, with microalbuminuria, and Group B, with normoalbuminuria. The association between pre-procedural microalbuminuria and the subsequent development of contrast-induced nephropathy (CIN) was evaluated using receiver operating characteristic (ROC) curve analysis. Results: A total of 164 patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI) were included. Of these, 67 (40.9%) had microalbuminuria (Group I), while 97 (59.1%) had normoalbuminuria (Group II). The mean age was 55.53 ± 11.66 years in Group I and 54.38 ± 10.71 years in Group II, with no significant difference (p=0.514). Age distribution was also comparable between the groups (p=0.762). The mean urinary albumin-to-creatinine ratio (uACR) was higher in Group I than in Group II (73.75 ± 5.60 vs. 16.24 ± 6.43 mg/g). Baseline serum creatinine levels were comparable between the groups (1.17 ± 0.14 vs. 1.15 ± 0.14 mg/dL; p=0.376). However, 48 hours after PCI, serum creatinine was significantly higher in Group I than in Group II (1.46 ± 0.33 vs. 1.28 ± 0.30 mg/dL; p=0.001). Contrast-induced nephropathy (CIN) developed in 39 patients (23.8%). The incidence was significantly higher in Group I than in Group II (35.8% vs. 15.5%; p=0.003). These findings indicate a significant association between pre-procedural microalbuminuria and an increased risk of CIN following PCI. Conclusion: Pre-procedure microalbuminuria is an important biochemical parameter for prediction development of CIN among patients with ACS undergoing PCI. Journal of National Institute of Neurosciences Bangladesh, January 2026;12(1):101-109