Abstract
Introduction: With the increased use of interventional therapies, the incidence of contrast-induced nephropathy (CIN) has also risen. However, the relationship between left ventricular end-diastolic pressure (LVEDP) levels and the risk of CIN remains unclear. Therefore, this study aimed to investigate the association between LVEDP and the risk of CIN using a systematic review and meta-analysis approach.
Materials and Methods: The study design followed the PRISMA protocol. Databases, including Cochrane, PubMed, ProQuest, Web of Science, and the Google Scholar search engine, were searched without time limitations until August 18, 2024. Data analysis was performed using STATA 14 software, with a significance level of P<0.05.
Results: Overall, increased LVEDP (OR: 1.29, 95% CI: 1.03, 1.63) was determined to be a risk factor for CIN. With regard to age, there were no differences in LVEDP levels and CIN risk in participants under 59 years of age (OR: 1.74, 95% CI: 0.87, 3.48) or in those aged 59 years and over (OR: 1.09, 95% CI: 0.67, 1.78). We found, LVEDP >18 mm Hg (OR: 2.04, 95% CI: 1.45, 2.86) was associated with an increased risk of CIN, while LVEDP ≤18 mm Hg (OR: 1.07, 95% CI: 0.53, 2.18) did not show any relation with CIN. Observational studies did not show any correlation between LVEDP and the risk of CIN (OR: 1.70, 95% CI: 0.94, 3.07). However, in randomized trials, the LVEDP was higher and associated with increased CIN risk (OR: 1.04, 95% CI: 1.01, 1.07). The odds of CIN were higher with higher LVEDP in the Americas (OR: 2.21, 95% CI: 1.40, 3.49), Europe (OR: 1.99, 95% CI: 1.08, 3.67), and Australia (OR: 3.40, 95% CI: 1.45, 7.97) but not in Asia (OR: 0.94, 95% CI: 0.78, 1.12). Furthermore, LVEDP was not a significant predictor of CIN in patients who were undergoing percutaneous coronary intervention (OR: 1.11, 95% CI: 0.90, 1.37), and an LVEF of <40% did not increase the risk of CIN (OR: 2.03, 95% CI: 0.95, 4.34).
Conclusion: LVEDP was a significant predictor of CIN and raised the risk by 29%. In addition, the highest risk was seen in Australia, the Americas, and Europe.
Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42024582053) and Research Registry (UIN: reviewregistry1877) website.