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Online Appendix for the following JACC article
TITLE: Renal Function-Based Contrast Dosing to Define Safe Limits of
Radiographic Contrast Media in Patients Undergoing Percutaneous Coronary
Interventions
AUTHORS: Hitinder S. Gurm, MD, Simon R. Dixon, MBChB, Dean E. Smith, PhD,
MPH, David Share, MD, Thomas LaLonde, MD, Adam Greenbaum, MD, Mauro
Moscucci, MD, MBA, for the Blue Cross Blue Shield of Michigan Cardiovascular
Consortium (BMC2) registry
APPENDIX
The variables included in the final multivariate model for both CIN and NRD were
age, gender; weight; baseline creatinine (mg/dL); creatinine clearance; history of
hypertension, diabetes, congestive heart failure, extra-cardiac vascular disease,
significant valve disease, prior PCI, prior CABG, chronic obstructive pulmonary
disease;
emergency PCI, Myocardial infarction within 7 days,
cardiac arrest,
cardiogenic shock, anemia, left ventricular ejection fraction < 50, left main stenosis >
70%, three vessel coronary disease, visible thrombus, and calcification.
Supplementary Table.
Baseline Characteristics of Study Patients compared with those excluded due to
absence of post PCI creatinine determination
Baseline Characteristics of Study Patients compared with those excluded due to
absence of post PCI creatinine determination
Risk Factor
Study cohort
Patients excluded
Demographic
N = 45,429
N = 9,097
p-value
Age (60-69)
28.5
29.6
0.04
Age (70-79)
23.0
24.2
0.02
Age (80+)
12.4
9.7
<0.0001
Female
34.1
33.6
0.33
Current Smoking
27.5
27.0
0.37
Lean (BMI <25)
18.5
16.5
<0.0001
Obese (BMI >30)
46.2
48.6
<0.0001
Hypertension
83.6
84.9
0.001
Prior MI
34.6
36.5
0.0004
Diabetes
35.6
33.6
0.0003
Congestive heart failure
15.9
11.8
<0.0001
Extracardiac vascular disease
26.3
24.1
<0.0001
Significant valve disease
3.98
2.44
<0.0001
Gastro-intestinal bleeding
1.68
0.69
<0.0001
Atrial Fibrillation
10.5
7.8
<0.0001
Cardiac arrest
1.30
1.15
0.26
Prior PCI
44.2
51.7
<0.0001
Prior CABG
19.5
20.2
0.12
COPD
19.6
19.0
0.19
Baseline creatinine >1.5 mg/dL
10.5
5.7
< 0.0001
Anemia
28.1
20.2
<0.0001
Historical
Laboratory
Ejection fraction < 50%
32.0
22.4
<0.0001
Emergency PCI
15.1
4.2
<0.0001
MI (prior 7 days)
33.3
14.9
<0.0001
Acute MI (<24 hrs.)
20.1
7.1
<0.0001
Cardiac arrest
1.49
0.57
<0.0001
Cardiogenic shock
1.75
0.56
<0.0001
Ventricular Tachycardia /
1.35
0.43
<0.0001
Left main stenosis >70%
3.76
3.11
0.002
Restenotic lesion
10.3
10.0
0.37
Visible thrombus
12.8
5.1
<0.0001
Calcification
12.3
14.8
<0.0001
Chronic total inclusion
2.05
2.47
0.01
Procedural
Fibrillation
The characteristics of patients who were excluded from the study due to absence of
missing post procedural creatinine compared with the study cohort.
Supplementary Figure Legends
Supplementary Figure 1. The incidence of CIN and NRD by deciles of Contrast
volume / Glomerular filtration rate (calculated using the MDRD equation). The
numbers under the solid bars reflect the range of contrast volume/MDRD GFR in
each decile.
Supplementary Figure 2. Unadjusted and adjusted odds of CIN and NRD by
exceeding Contrast volume / glomerular filtration rate (calculated using the MDRD
equation) ratio of 2, 2.5 and 3. The adjusted risk of renal complications approaches
significance when CV/GFR exceeds 2 and is strongly predictive when the ratio
exceeds 3.