Impact of contrast-induced acute kidney injury on patients with acute coronary syndrome: results of a prospective cohort

Contrast-induced acute kidney injury (CI-AKI) remains a relevant complication in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), with important prognostic implications. This prospective cohort study evaluated factors associated with CI-AKI and its impact on short- to medium-term survival in patients with ACS treated with PCI. Patients were followed for 90 days between December 2019 and February 2021, with collection of sociodemographic, clinical, laboratory, and procedural data. CI-AKI incidence was analyzed using Poisson regression to estimate relative risks, and survival was assessed using a multivariable Cox proportional hazards model. 192 patients were analyzed, CI-AKI occurred in 33% of patients and was independently associated with advanced age, hypertension, chronic kidney disease, use of vasoactive drugs, and cardiorespiratory arrest. Mortality was 15% higher among patients who developed CI-AKI, and its occurrence was associated with a 4.7-fold increased hazard of death within 90 days, remaining an independent predictor after adjustment. These findings indicate that CI-AKI is a frequent and clinically relevant manifestation of cardiorenal interaction in ACS, strongly associated with increased medium-term mortality, underscoring the importance of early identification and preventive strategies in this high-risk population.