Association between acute-to-chronic glucose ratio and acute kidney injury after emergency PCI in patients with acute myocardial infarction.

BACKGROUND

Contrast-induced acute kidney injury (CI-AKI) is a common complication in patients with acute myocardial infarction undergoing Percutaneous coronary intervention (PCI) treatment and is associated with poor prognosis. there is a lack of effective predictive biomarkers and functions.

OBJECTIVE

To explore the correlation between the acute-to-chronic blood glucose ratio (ARC) and CI-AKI in patients with emergency PCI.

METHODS

This study enrolled AMI patients undergoing emergency PCI from November 2018 to May 2024. Demographic characteristics, medical history, and perioperative laboratory parameters were systematically collected. Potential predictors were identified through least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression. Restricted cubic splines (RCS) were employed to examine nonlinear relationships, with subsequent subgroup analyses and nomogram construction.

RESULTS

A total of 502 patients were included, with 84 developing postoperative CI-AKI and 418 remaining non-CI-AKI. ARC was found to be an independent risk factor for CI-AKI (OR = 1.06, 95 % CI 1.04-1.08). RCS analysis revealed a non-linear relationship between ARC and CI-AKI. In various adjusted models, ARC as a continuous variable showed a correlation with CI-AKI occurrence. In the third and fourth quantiles, ARC was independently associated with CI-AKI risk (OR = 2.95, 95 % CI 1.16-7.47 and OR = 7.17, 95 % CI 2.99-17.24, respectively). The nomogram model, based on LASSO regression, demonstrated good predictive accuracy for CI-AKI (AUC = 0.831, 95 % CI 0.778-0.884).

CONCLUSION

There is a non-linear positive correlation between ARC and the risk of acute kidney injury after emergency PCI in patients with AMI.