Clinical impact of noncontrast percutaneous coronary intervention in patients with acute coronary syndrome

Purpose : Contrast-induced acute kidney injury (CI-AKI) is one of the common serious complications of percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). This study aimed to assess the significance of noncontrast strategy in the setting of ACS. Methods : CI-AKI was defined as an increase in serum creatinine of ≥ 0.5 mg / dL or ≥ 1.25 times from the baseline. One-year worsening renal function (WRF) was defined as an increase of ≥ 0.3 mg / dL in serum creatinine from the baseline after PCI. Results : Of 250 ACS patients, 81 were treated with noncontrast PCI. The average doses of contrast medium in the noncontrast and conventional groups were 17 (9–22) ml and 150 (120–200) ml, respectively. CI-AKI was observed in 4 patients (5%) in the noncontrast group and 29 patients (17%) in the conventional group. Noncontrast PCI was associated with a lower incidence of CI-AKI (adjusted odds ratio, 0.26 ; 95% confidence interval [CI], 0.08–0.82). The bootstrap method and inverse probability weighting led to similar results. CI-AKI was associated with a higher incidence of 1-year WRF (adjusted hazard ratio, 2.30 ; 95% CI, 1.12–4.69), while noncontrast PCI was not. Conclusions : Noncontrast PCI was associated with the lower incidence of CI-AKI in ACS patients.