Predictive value of systemic immune-inflammation index and NT-proBNP for contrast-induced acute kidney injury in elderly STEMI patients
10.3969/j.issn.1009-0126.2024.01.007
- VernacularTitle:系统性免疫炎症指数和N末端B型钠尿肽前体对老年患者对比剂急性肾损伤的预测价值
- Author:
Guoqi SHEN
1
;
Linsheng WANG
;
Xudong ZHANG
;
Luhong XU
;
Fangfang LI
;
Jing ZONG
;
Tongda XU
;
Wenhua LI
Author Information
1. 221002 徐州医科大学第一临床医学院
- Keywords:
myocardial infarction;
percutaneous coronary intervention;
acute kidney injury;
natri-uretic peptide,brain;
forecasting;
systemic immune-inflammation index
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(1):25-29
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of systemic immune-inflammation index(SII)and N-terminal pro-brain natriuretic peptide(NT-proBNP)level in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)developing contrast-induced acute kidney injury(CIAKI)after PCI.Methods A total of 1085 elderly STEMI patients undergoing emergency PCI in the Affiliated Hospital of Xuzhou Medical University from January 2018 to March 2023 were consecutively recruited as a training set,and another 287 elderly STEMI pa-tients receiving emergency PCI in the East Branch of the Affiliated Hospital from January 2021 to June 2023 were included as a verification set.According to the diagnostic criteria of CIAKI,they were divided into CIAKI group(n=95)and non-CIAKI group(n=990).Based on the results of restricted cubic spline(RCS)analysis,the patients from the training set were assigned into low-risk subgroup(n=292),moderate-risk group(n=515)and high-risk group(n=278).Multivari-ate logistic regression analysis was used to analyze the independent risk factors of CIAKI in elder-ly STEMI patients after PCI,and ROC curve was plotted to analyze the predictive value of combi-nation of SII and NT-proBNP.The risk of CIAKI was compared among the patients at different risk grades.Results Age,SII,baseline serum creatinine,NT-proBNP,fasting blood glucose and use of diuretics were independent risk factors for CIAKI after primary PCI in elderly STEMI patients(P＜0.05,P＜0.01).The AUC value of SII combined with NT-proBNP in predicting CIAKI was 0.801(95％CI:0.761-0.842,P＜0.01),with a sensitivity of 83.2％and a specificity of 67.5％,both superior to that of SII or NT-proBNP alone.RCS analysis revealed an increased risk of CIAKI at SII ≥1084.97 × 109/L and NT-proBNP ≥296.12 ng/L.The incidence of CIAKI was increased with the increase of risk grades(1.71％vs 6.41％vs 20.50％).Conclusion SII and NT-proBNP are independent risk factors for CIAKI after emergency PCI in elderly STEMI pa-tients.And their combination has better predictive value for CIAKI.
