Deng Yifan, Ma Yue, Gao Jiapei, Sun Qinyu, Zhang Jing, Zhu Li
Northern Jiangsu People's Hospital, Yangzhou, 225001, PR China; Taizhou People's Hospital affiliated to Nanjing Medical University, Taizhou, 225300, Jiangsu, PR China; Medical College of Yangzhou University, Yang zhou 225001, PR China.
Yangzhou Hanjiang District Maternal and Child Health HospitalPR China.
Heart Lung. 2025 Sep-Oct;73:48-55. doi: 10.1016/j.hrtlng.2025.04.025. Epub 2025 Apr 25.
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.
To explore the correlation between the acute-to-chronic blood glucose ratio (ARC) and CI-AKI in patients with emergency PCI.
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.
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).
There is a non-linear positive correlation between ARC and the risk of acute kidney injury after emergency PCI in patients with AMI.
造影剂诱导的急性肾损伤（CI-AKI）是接受经皮冠状动脉介入治疗（PCI）的急性心肌梗死患者常见的并发症，且与预后不良相关。目前缺乏有效的预测生物标志物和功能。
探讨急诊PCI患者急性与慢性血糖比值（ARC）与CI-AKI之间的相关性。
本研究纳入了2018年11月至2024年5月接受急诊PCI的急性心肌梗死患者。系统收集人口统计学特征、病史和围手术期实验室参数。通过最小绝对收缩和选择算子（LASSO）回归和多变量逻辑回归确定潜在预测因素。采用受限立方样条（RCS）检验非线性关系，随后进行亚组分析和列线图构建。
共纳入502例患者，其中84例术后发生CI-AKI，418例未发生CI-AKI。ARC被发现是CI-AKI的独立危险因素（OR = 1.06，95%CI 1.04-1.08）。RCS分析显示ARC与CI-AKI之间存在非线性关系。在各种调整模型中，ARC作为连续变量与CI-AKI的发生相关。在第三和第四四分位数中，ARC与CI-AKI风险独立相关（OR分别为2.95，95%CI 1.16-7.47和OR = 7.17，95%CI 2.99-17.24）。基于LASSO回归的列线图模型对CI-AKI具有良好的预测准确性（AUC = 0.831，95%CI 0.778-0.884）。
AMI患者急诊PCI后ARC与急性肾损伤风险之间存在非线性正相关。
