***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The prognostic relevance of direct contrast toxicity in patients treated with primary percutaneous coronary intervention  remains unclear , owing to the confounding hemodynamic effect of acute left ventricular ejection fraction ( LVEF ) impairment on kidney function estimation . In the present study , 644 consecutive patients with ST-segment elevation myocardial infa rct ion undergoing primary percutaneous coronary intervention were prospect ively enrolled .  Contrast-induced nephropathy ( CIN ) was defined as an increase in serum creatinine > 25 % or a decrease in the estimated glomerular filtration rate ( eGFR ) < 25 % from baseline in the first 72 hours . The primary end point of the study was major adverse cardiovascular events at 1 year ( composite of death , myocardial infa rct ion , target lesion revascularization , and bleeding ) . Among the global population , the interaction between the LVEF and eGFR at admission to define CIN was statistically significant ( p < 0.001 ) . When only the 385 patients without acute LVEF impairment ( i.e. , those with LVEF ≥40 % ) were considered , 27 ( 7 % ) developed postprocedural CIN that was associated with increased major adverse cardiovascular events rate at 1 year of clinical follow-up ( 38 % vs 9 % ; p < 0.001 ) . On adjusted Cox multivariate analysis , CIN was an independent predictor of worse outcomes , both when defined according to creatinine ( hazard ratio 3.81 , 95 % confidence interval 1.71 to 8.48 , p = 0.001 ) or eGFR ( hazard ratio 3.77 , 95 % confidence interval 1.53 to 9.28 , p = 0.004 ) variations . In conclusion , in patients with ST-segment elevation myocardial infa rct ion undergoing primary percutaneous coronary intervention  , LVEF has a significant interaction with eGFR . When only patients without acute LVEF impairment were considered , CIN confirmed its negative prognostic effect on the 1-year clinical outcomes Iodine and gadolinium-based contrast induced nephropathy is the third leading cause of hospital-acquired acute kidney injury . It is essentially observed in patients with defined risk factors and is associated with increased morbidity and mortality . The prevention of contrast induced nephropathy consists in volume expansion through intravenous sodium chloride 0.9 % or sodium bicarbonate 1.4 % . Comparative r and omized controlled trials appear to show a benefit in favor of sodium bicarbonate over saline fluids . According to last evidence , N-acetylcysteine does not provide additional benefit over intravenous fluids BACKGROUND The Logistic Clinical Syntax Score ( log CSS ) is a combined risk scoring system that includes clinical and anatomic parameters ; it has been found to be effective for the prediction of mortality in patients with ST-elevation myocardial infa rct ion ( STEMI ) . The aim of the present study was to assess whether the log CSS was associated with the development of contrast-induced nephropathy ( CIN ) in patients who underwent primary percutaneous coronary intervention ( pPCI ) .  METHODS A total of 930 patients with STEMI undergoing pPCI between January 2012 and August 2013 were included prospect ively . The patients were grouped according to the development of CIN . Either an absolute serum creatinine level ≥ 0.5 mg/dL or a 25 % increase in the serum creatinine level compared with the baseline level within 48 hours after the administration of contrast medium was defined as CIN . RESULTS The Synergy Between Percutaneous Coronary Interventions With Taxus and Cardiac Surgery score ( SYNTAX [ SS ] ) and log CSS were higher in patients with CIN than in those without . In the multivariate analysis , log CSS ( odds ratio , 1.405 , 95 % confidence interval , 1.318 - 1.497 ; P < 0.001 ) , hemoglobin , and contrast volume were found to be independent predictors of CIN . In the receiver operating characteristic analysis , a log CSS > 9.5 had a 74.5 % sensitivity and a 90.5 % specificity for predicting CIN , with an area under the curve ( AUC ) of 0.892 , whereas an SS > 18.5 had a 64 % sensitivity , a 58.1 % specificity , and an AUC of 0.625 ( 0.892 vs 0.625 ; P < 0.001 ) . A log CSS > 9.5 was associated with in-hospital and long-term mortality , reinfa rct ion , revascularization , and in-hospital hemodialysis ( P < 0.001 for each ) . CONCLUSIONS The log CSS may improve the accuracy of risk stratification for the development of CIN in patients undergoing pPCI OBJECTIVES The National Cardiovascular Data Registry ( NCDR ) developed the Data Quality Program to meet the objectives of ensuring the completeness , consistency , and accuracy of data su bmi tted to the observational clinical registries . The Data Quality Program consists of 3 main components : 1 ) a data quality report ; 2 ) a set of internal quality assurance protocol s ; and 3 ) a yearly data audit program . BACKGROUND Since its inception in 1997 , the NCDR has been the basis for the development of performance and quality metrics , site-level quality improvement programs , and peer- review ed health outcomes research . METHODS Before inclusion in the registry , data are filtered through the registry-specific algorithms that require predetermined levels of completeness and consistency for su bmi tted data fields as part of the data quality report . Internal quality assurance protocol s enforce data st and ards before reporting . Within each registry , 300 to 625 records are audited annually in 25 r and omly identified sites ( i.e. , 12 to 25 records per audited site ) . RESULTS In the 2010 audits , the participant average raw accuracy of data abstract ion for the CathPCI Registry , ICD Registry , and ACTION Registry-GWTG were , respectively , 93.1 % ( range , 89.4 % minimum , 97.4 % maximum ) , 91.2 % ( range , 83.7 % minimum , 95.7 % maximum ) , and 89.7.% ( range , 85 % minimum , 95 % maximum ) . CONCLUSIONS The 2010 audits provided evidence that many fields in the NCDR accurately represent the data from the medical charts . The American College of Cardiology Foundation is undertaking a series of initiatives aim ed at creating a quality assurance rapid learning system , which , when complete , will monitor , evaluate , and improve data quality OBJECTIVES We sought to develop a simple risk score of contrast-induced nephropathy ( CIN ) after percutaneous coronary intervention ( PCI ) .  BACKGROUND Although several risk factors for CIN have been identified , the cumulative risk rendered by their combination is unknown . METHODS A total of 8,357 patients were r and omly assigned to a development and a validation data set . The baseline clinical and procedural characteristics of the 5,571 patients in the development data set were considered as c and i date univariate predictors of CIN ( increase > or=25 % and /or > or=0.5 mg/dl in serum creatinine at 48 h after PCI vs. baseline ) . Multivariate logistic regression was then used to identify independent predictors of CIN with a p value < 0.0001 . Based on the odds ratio , eight identified variables ( hypotension , intra-aortic balloon pump , congestive heart failure , chronic kidney disease , diabetes , age > 75 years , anemia , and volume of contrast ) were assigned a weighted integer ; the sum of the integers was a total risk score for each patient . RESULTS The overall occurrence of CIN in the development set was 13.1 % ( range 7.5 % to 57.3 % for a low [ < or=5 ] and high [ > or=16 ] risk score , respectively ) ; the rate of CIN increased exponentially with increasing risk score ( Cochran Armitage chi-square , p < 0.0001 ) . In the 2,786 patients of the validation data set , the model demonstrated good discriminative power ( c statistic = 0.67 ) ; the increasing risk score was again strongly associated with CIN ( range 8.4 % to 55.9 % for a low and high risk score , respectively ) . CONCLUSIONS The risk of CIN after PCI can be simply assessed using readily available information . This risk score can be used for both clinical and investigational purpose Abstract Objective : Neutrophil gelatinase-associated lipocalin ( NGAL ) is produced in response to tubular injury . Contrast-induced acute kidney injury ( CI-AKI ) is associated with adverse outcomes in chronic kidney disease ( CKD ) patients . We sought to characterize blood NGAL level and the degree of kidney injury in CKD patients who underwent coronary angiography .  Methods : This study was a prospect i ve , blinded assessment of blood sample s obtained from patients with estimated glomerular filtration rates ( eGFRs ) between 15 and 90 mL/min/1.73 m2 undergoing elective coronary angiography with iodinated contrast .  Blood NGAL and serum creatinine were measured at baseline , 1 , 2 , 4 , 6 , 12 , 24 and 48 h after contrast administration . Results : A total of 63 subjects with a mean eGFR of 48.17 ± 16.45 mL/min/1.73 m2 were enrolled . There was a grade d increase in baseline NGAL levels across worsening stages of CKD ( p = 0.0001 ) . Post-procedure NGAL increased from baseline in each stage of CKD . Eight ( 12.7 % ) patients were diagnosed with CI-AKI by diagnostic criteria of 2012 KDIGO definition of CI-AKI , and seven ( 11.1 % ) patients developed sub clinical CI-AKI defined by a twofold or greater rise in NGAL . There was no relationship between baseline eGFR and diabetes on the composite outcome of sub clinical and clinical CI-AKI . Conclusions : Baseline and post-procedure NGAL are progressively elevated according to the baseline stage of CKD . Using a twofold rise in NGAL , 46.7 % of composite CI-AKI is detected and complements the 53.3 % of cases identified using KDIGO criteria . Traditional risk predictors were not independently associated with this composite outcome 
    Output:
    
It was found to predict CIN and major adverse cardiac events in several studies but a simpler preprocedure tool could be more practical for the prediction of CIN .