The effect of totally occluded infarct artery on the development of contrast nephropathy in patients with percutaneous coronary intervention DUE to acute myocardial infarction

Aims: The aim of our study is toinvestigated the effect of the TIMI Thrombus Grade class of the initial infarct-related artery on the development of contrast media nephropathy (CIN) in patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Materials and Methods: Our study was planned as a single-center, prospective study. The study included 389 patients who underwent emergency PCI with the diagnosis of AMI in our institution between May 2019 and April 2022. Demographic and clinical characteristics of the patients were recorded. Serum creatinine levels were examined preoperatively and 48-72 h postoperatively. According to the increase in creatinine levels, the patients were divided into two groups as developing and not developing CIN.Risk factors that may cause the development of CIN were evaluated. According to the TIMI thrombus grade score, the patients were divided into two groups as TIMI (0-4) and TIMI (5). Clinical, demographic and laboratory characteristics were compared according to TIMI thrombus grade scores. Results: CIN was detected in 59 (15,2%) patients.In terms of development of CIN in AMI patients who underwent emergency PCI; patient's age (p<0,001), previous use of ACE inhibitor (p=0,018) and beta-blocker (p=0,017), low baseline GFR before the procedure (p<0,001), low hemoglobin (p=0,001) and contrast material amount (p=0,005) were found significant. It was found that the baseline GFR before the procedure (p=0,005) and the amount of contrast material used (p=0,007) were independent factors in the development of CIN. It was found that 31,9% of the patients who underwent PCI had totally occlusion of the infarct-related artery with thrombosis. There was no statistically significant correlation between totally occlusion of the infarct-related artery and CIN (p=0,203). In terms of predicting totally occluded infarct-related artery; platelet, AST and ALT levels were detected significantly (p=0,019, p=0,002, p=0,001, respectively). Conclusion: It was found that 31,9% of the patients who underwent PCI for AMI had complete occlusion of the infarct-related artery with thrombosis. No significant correlation was found between complete occlusion of the infarct-related artery and the risk of developing CIN. In terms of complete occlusion of the infarct-related artery; platelet, AST and ALT elevations were significant. Key words: Acute myocardial infarction, percutaneous coronary intervention, contrast induced nephropathy, thrombus burden, TIMI thrombus grade