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高敏C反应蛋白与高密度脂蛋白胆固醇比值及经皮冠状动脉介入治疗患者发生造影剂诱导的急性肾损伤的风险

The High-Sensitivity C-Reactive Protein to High-Density Lipoprotein Cholesterol Ratio and the Risk of Contrast-Induced Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Intervention.

作者信息

Deng Linxiao, Chen Hua, Xu Qingbo, Han Kedong, Liu Jin, Chen Shiqun, Deng Jingru, Tian Leigang, Li Zeliang, Lu Xiaozhao, Liu Yong, Liang Yan

机构信息

The First Clinical School of Medicine, Guangdong Medical University, 524000 Zhanjiang, Guangdong, China.

Department of Cardiology, Maoming People's Hospital, 525099 Maoming, Guangdong, China.

出版信息

Rev Cardiovasc Med. 2024 Sep 23;25(9):338. doi: 10.31083/j.rcm2509338. eCollection 2024 Sep.

Abstract

BACKGROUND

The high-sensitivity C-reactive protein to high-density lipoprotein cholesterol ratio (CHR) is a novel biomarker associated with coronary artery disease (CAD) risk. This study aimed to analyze the relationship between CHR and contrast-induced acute kidney injury (CI-AKI).

METHODS

This retrospective cross-sectional research included 10,917 individuals who underwent PCI. CI-AKI was diagnosed using the Kidney Disease: Improving Global Outcomes (KIDIGO) standard. Univariate and multivariable logistic regression analyses were conducted to examine the association between CHR and CI-AKI, followed by a receiver operating characteristic (ROC) curve of participants to assess the clinical diagnostic performance of CHR on CI-AKI.

RESULTS

A total of 1037 patients (9.50%) developed CI-AKI after PCI. The age of individuals averaged 64.1 ± 11.1 years old, with 2511 females (23.0%). A multivariate logistic regression study revealed that higher CHR levels were linked to higher CI-AKI incidence rates ([Q4 vs. Q1]: odds ratio (OR) = 1.89, 95% confidence interval (CI) [1.42 to 2.54], < 0.001). A restricted cubic spline analysis revealed a linear association between CHR and CI-AKI. ROC analysis indicated that CHR was an excellent predictor of CI-AKI (area under ROC curve = 0.606, 95% CI [0.588 to 0.624]).

CONCLUSIONS

A high CHR level is strongly associated with increased CI-AKI incidence, suggesting that CHR may be an independent risk factor for CI-AKI.

CLINICAL TRIAL REGISTRATION

NCT05050877. https://clinicaltrials.gov/study/NCT05050877?tab=results.

摘要

背景

高敏C反应蛋白与高密度脂蛋白胆固醇比值(CHR)是一种与冠状动脉疾病(CAD)风险相关的新型生物标志物。本研究旨在分析CHR与造影剂诱导的急性肾损伤(CI-AKI)之间的关系。

方法

这项回顾性横断面研究纳入了10917例行PCI的患者。采用改善全球肾脏病预后组织(KIDIGO)标准诊断CI-AKI。进行单因素和多因素逻辑回归分析以检验CHR与CI-AKI之间的关联,随后绘制受试者工作特征(ROC)曲线以评估CHR对CI-AKI的临床诊断性能。

结果

共有1037例患者(9.50%)在PCI后发生CI-AKI。患者年龄平均为64.1±11.1岁,女性2511例(23.0%)。多因素逻辑回归研究显示,较高的CHR水平与较高的CI-AKI发病率相关([四分位数4 vs. 四分位数1]:比值比(OR)=1.89,95%置信区间(CI)[1.42至2.54],<0.001)。限制立方样条分析显示CHR与CI-AKI之间存在线性关联。ROC分析表明,CHR是CI-AKI的优秀预测指标(ROC曲线下面积=0.606,95%CI[0.588至0.624])。

结论

高CHR水平与CI-AKI发病率增加密切相关,提示CHR可能是CI-AKI的独立危险因素。

临床试验注册

NCT05050877。https://clinicaltrials.gov/study/NCT05050877?tab=results。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f78a/11440391/b053317b3de0/2153-8174-25-9-338-g1.jpg

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