IntroductionContrast-induced acute kidney injury (CI-AKI) after PCI predicts worse cardiovascular outcomes. Physiologic mechanisms, genetic predisposition and socioeconomic disparities related to ethnicity may contribute to the occurrence of CI-AKI.HypothesisWe evaluated the risk of CI-AKI after PCI according to ethnicity and its subsequent impact on 1-year mortality.MethodsPatients undergoing PCI at our Institution from 2009-2018 were grouped by ethnicity into White (n=7,942), Asian (n=2,604), Hispanic (n=1,431) and African American (n=1,748). CI-AKI was defined as a peri-procedural creatinine increase of >0.3 mg/dL or >50% compared to baseline. The association between ethnicity and CI-AKI was assessed using logistic regression. A sensitivity analysis was performed by including only patients with baseline CKD, defined as eGFR <60 mL/min/1.73m. The risk of 1-year mortality after CI-AKI was evaluated with multivariate Cox model.ResultsThe rate of CI-AKI was 5.8% in the overall population. Compared to White patients, the risk of CI-AKI was higher in African Americans (OR 1.45, 95% CI 1.19-1.76; p<0.001), lower in Asians (OR 0.78, 95% CI 0.65-0.98; p=0.03) and similar in Hispanics (OR 0.93, 95% CI 0.73-1.19; p=0.57). However, after adjustment for confounders, the association between ethnicity and CI-AKI was largely attenuated (Figure). Findings of sensitivity analysis in CKD patients were consistent with those in the general population. Overall, 1-year mortality was increased in patients who experienced CI-AKI (adjusted HR 1.92, 95% CI 1.39-2.66; p<0.001), but this risk was not uniform among the different subgroups (Whitep<0.001, African Americanp=0.05, Hispanicp=0.06, Asianp=0.37) (Figure).ConclusionsThe risk of CI-AKI after PCI varies according to ethnicity, however, this might be explained by differences in risk factors observed in each group. The occurrence of CI-AKI is associated with an increased risk of mortality at 1 year.