The MENT Score: A Simplified Tool to Predict Contrast-Induced Nephropathy After Percutaneous Coronary Intervention — Derivation and External Validation

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Background: Contrast-induced nephropathy (CIN) remains a significant and potentially preventable complication following percutaneous coronary intervention (PCI), linked to increased morbidity, prolonged hospitalization, and higher mortality. Existing risk scores such as CHA₂DS₂-VASc and the Mehran Risk Score (MRS) fail to capture the full spectrum of risk factors.Objective: To develop and validate the MENT Score (Multifactorial Evaluation for Nephropathy after Transcatheter Intervention), a streamlined predictive model that integrates key clinical and procedural variables from CHA₂DS₂-VASc, MRS, and PCI urgency.Methods: In this prospective study, 1000 consecutive PCI patients were enrolled—500 for derivation and 500 for validation. CIN was defined as a ≥25% or ≥0.5 mg/dL rise in serum creatinine within 48 hours post-procedure. Variables from established risk models and PCI-related factors were assessed through multivariable logistic regression.Results: Six independent predictors were incorporated into the MENT Score: female sex (p=0.009), diabetes mellitus (p=0.002), peripheral arterial disease (p=0.021), contrast volume ≥200 mL (p=0.060), systolic blood pressure ≤80 mmHg or inotrope use (p=0.0005), and baseline serum creatinine >1.5 mg/dL (p=0.043). A score >3 yielded strong discriminatory power:Derivation cohort: AUC = 0.770, sensitivity = 52.5%, specificity = 91.6%, accuracy = 82.4% Validation cohort: AUC = 0.861, outperforming MRS (0.76) and CHA₂DS₂-VASc (0.71) Conclusion: The MENT Score offers a concise, clinically relevant tool for early CIN risk stratification in PCI patients. Its superior predictive accuracy and ease of use make it a promising alternative to existing models, with potential to guide targeted preventive strategies.

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