Medical School of Southeast University, Nanjing, China.
Department of Cardiology, School of Medicine, Southeast University Zhongda Hospital, Nanjing, China.
Angiology. 2024 Oct;75(9):831-840. doi: 10.1177/00033197231185445. Epub 2023 Jun 19.
The present study aimed to evaluate the predictive role of inflammatory biomarkers in the development of contrast-induced acute kidney injury (CI-AKI) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The inflammatory biomarkers assessed were: platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), neutrophil-to-lymphocyte*platelet ratio (NLPR), systemic inflammatory index (SII), and systemic inflammation response index (SIRI). Overall, 950 patients undergoing PCI were enrolled. The frequency of CI-AKI was 15.2% (n = 144). The levels of NLR, MLR, NLPR, SII, and SIRI were higher in the CI-AKI group than in the Non-CI-AKI group (P < .05). The addition of NLR ≥2.96, dNLR ≥2.08, NLPR ≥.012, SII ≥558.04, and SIRI ≥1.13 to the Mehran score model significantly increased the area under the curve (P < .05). Multivariable logistic regression analyses indicated that inflammatory biomarkers were significantly associated with CI-AKI, including NLR ≥2.96 (OR = 1.588, P = .017), dNLR ≥2.08 (OR = 1.686, P = .007), SII ≥558.04 (OR = 1.521, P = .030), and SIRI ≥1.13 (OR = 1.601, P = .017). Therefore, inflammation is associated with the development of CI-AKI, and preoperative hematological inflammatory markers could predict the risk of CI-AKI in ACS patients undergoing PCI.
本研究旨在评估炎症生物标志物在接受经皮冠状动脉介入治疗(PCI)的急性冠状动脉综合征(ACS)患者中对比剂诱导的急性肾损伤(CI-AKI)发展中的预测作用。评估的炎症生物标志物包括血小板与淋巴细胞比值(PLR)、单核细胞与淋巴细胞比值(MLR)、中性粒细胞与淋巴细胞比值(NLR)、衍生中性粒细胞与淋巴细胞比值(dNLR)、中性粒细胞与淋巴细胞*血小板比值(NLPR)、全身炎症指数(SII)和全身炎症反应指数(SIRI)。共有 950 名接受 PCI 的患者入组。CI-AKI 的发生率为 15.2%(n=144)。CI-AKI 组的 NLR、MLR、NLPR、SII 和 SIRI 水平均高于非 CI-AKI 组(P<.05)。将 NLR≥2.96、dNLR≥2.08、NLPR≥.012、SII≥558.04 和 SIRI≥1.13 加入 Mehran 评分模型显著增加了曲线下面积(P<.05)。多变量逻辑回归分析表明,炎症生物标志物与 CI-AKI 显著相关,包括 NLR≥2.96(OR=1.588,P=.017)、dNLR≥2.08(OR=1.686,P=.007)、SII≥558.04(OR=1.521,P=.030)和 SIRI≥1.13(OR=1.601,P=.017)。因此,炎症与 CI-AKI 的发生有关,术前血液学炎症标志物可预测 ACS 患者 PCI 后 CI-AKI 的风险。