Department of Cardiology, Saglik Bilimleri University, Istanbul Training and Research Hospital, Istanbul, Turkey.
Department of Nephrology, Saglik Bilimleri University, Istanbul Training and Research Hospital, Istanbul, Turkey.
Angiology. 2023 Sep;74(8):736-744. doi: 10.1177/00033197221116203. Epub 2022 Aug 14.
This study evaluated the effectiveness of prognostic nutritional index (PNI) in predicting contrast induced nephropathy (CIN) in patients with acute coronary syndrome (ACS). This study included 925 ACS patients (mean age 62.5 ± 12.4 years, 73.5% male); 604 were diagnosed as unstable angina pectoris/non-ST-elevation myocardial infarction (USAP/NSTEMI) and 321 as ST-elevation myocardial infarction (STEMI). The PNI formula was: 10 × serum albumin (g/dL) + .005 × total lymphocyte count (/mm). The patients were divided into two groups: CIN (n = 232) and non-CIN (n = 693). Patients without CIN had a significantly lower PNI than patients with CIN (44.3 ± 6.9 54.7 ± 7.4; < .001). In the receiver operating characteristic (ROC) curve analysis, the cut-off value for PNI of 48.6 has 80% specificity and 81% sensitivity in predicting CIN (area under the ROC curve (AUC): .87, 95% CI [.84-.89]). PNI <48.6 (odds ratio (OR): 6.765, < .001), pre-procedural creatinine levels (OR: 6.223, < .001), left ventricular ejection fraction (LVEF) (OR: .960, < .001), age (OR: 1.025, = .005), diabetes mellitus (DM) (0R: 1.768, = .006), contrast amount (OR: 1.003, = .038), and having STEMI (OR: .594, = .029) were found independently associated with CIN. PNI is a strong independent predictor of CIN in ACS patients.
本研究评估了预后营养指数（PNI）在预测急性冠脉综合征（ACS）患者对比剂诱导肾病（CIN）中的有效性。本研究纳入了 925 例 ACS 患者（平均年龄 62.5±12.4 岁，73.5%为男性）；其中 604 例诊断为不稳定型心绞痛/非 ST 段抬高型心肌梗死（USAP/NSTEMI），321 例为 ST 段抬高型心肌梗死（STEMI）。PNI 公式为：血清白蛋白（g/dL）×10+.005×总淋巴细胞计数（/mm）。患者被分为两组：CIN（n=232）和非 CIN（n=693）。无 CIN 患者的 PNI 显著低于 CIN 患者（44.3±6.9 vs. 54.7±7.4；<.001）。在受试者工作特征（ROC）曲线分析中，PNI 截断值为 48.6 时，预测 CIN 的特异性和敏感性分别为 80%和 81%（ROC 曲线下面积（AUC）：.87，95%CI [.84-.89]）。PNI<48.6（比值比（OR）：6.765，<.001）、术前血肌酐水平（OR：6.223，<.001）、左心室射血分数（LVEF）（OR：.960，<.001）、年龄（OR：1.025，=.005）、糖尿病（DM）（OR：1.768，=.006）、造影剂用量（OR：1.003，=.038）和 STEMI（OR：.594，=.029）与 CIN 独立相关。PNI 是 ACS 患者 CIN 的一个强有力的独立预测因子。
