Validation of a Contemporary Acute Kidney Injury Risk Score in Patients With Acute Coronary Syndrome
Authors' conclusion
The updated CA-AKI risk score identifies patients at incremental risks of acute kidney injury, bleeding, and mortality.
Study context
- Population
- ACS patients in the MATRIX trial with complete creatinine values and no end-stage renal disease
- Participants
- 8,201 patients
- Comparison
- 8-component vs 12-component contrast-associated acute kidney injury (CA-AKI) risk model
- Primary endpoint
- ROC characteristics of the 8-component and 12-component CA-AKI models
Methodological detailsexternal validation of a risk score
- External validation of a risk score
Primary result
As reported in the abstract
Discrimination for CA-AKI
| Group | AUC |
|---|---|
| Model 1 | 0.67 (95% CI: 0.64-0.70) |
| Model 2 | 0.71 (95% CI: 0.68-0.74) |
AUC
Model 10.67 (95% CI: 0.64-0.70)
Model 20.71 (95% CI: 0.68-0.74)
- CA-AKI risk systematically overestimated with both models (Hosmer-Lemeshow goodness-of-fit test)
- P < 0.05
Further findings
All-cause mortality and bleeding, CA-AKI vs no CA-AKI · 1 year
| HR (95% CI) | ||
|---|---|---|
| CA-AKIAll-cause mortality | 7.03 (5.47–9.05) | |
| CA-AKIBleeding | 3.20 (2.56–3.99) | |
| 0.10.31310Hazard ratio (log scale) |
CA-AKI incidence
- CA-AKI occurred
- 5.5%
- Stepwise increase of CA-AKI rates from lowest to highest of the 4 risk categories
All-cause mortality and bleeding, CA-AKI vs no CA-AKI · 1 year
- Gradual risk increase for mortality and bleeding by CA-AKI risk category for both models
Original publication
Validation of a Contemporary Acute Kidney Injury Risk Score in Patients With Acute Coronary Syndrome. JACC Cardiovasc Interv. Published 14 August 2023. doi:10.
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