Predictive value of cystatin C and antithrombin Ⅲ for contrast-induced acute kidney injury in elderly hypertensive patients
10.3969/j.issn.1009-0126.2024.08.002
- VernacularTitle:胱抑素C和抗凝血酶Ⅲ对老年高血压患者造影剂急性肾损伤的预测价值
- Author:
Linsheng WANG
1
;
Xudong ZHANG
;
Yuan LU
;
Jing ZONG
;
Fangfang LI
;
Luhong XU
;
Wenhua LI
Author Information
1. 221002 徐州医科大学第一临床医学院
- Keywords:
hypertension;
acute kidney injury;
Cystatin C;
antithrombin Ⅲ;
forecasting
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(8):862-866
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of Cys C and AT Ⅲ for CIAKI in elderly hypertensive patients with AMI after PCI.Methods A total of 911 elderly hypertensive patients with AMI undergoing emergency PCI in the Affiliated Hospital of Xuzhou Medical University from January 2019 to May 2023 were consecutively enrolled,and then randomly divided into a training group(731 cases)and a validation group(180 cases)in a ratio of 8∶2.According to the diagnostic criteria of CIAKI defined by the European Society of Urogenital Radiology,the patients of the training group were further divided into CIAKI subgroup(n=91)and non-CIAKI sub-group(n=640).The basic clinical data were compared between the CIAKI and non-CIAKI sub-groups and between the training and validation groups.Multivariate logistic regression analysis was used.ROC curve was drawn to analyze the predictive value of Cys C,ATⅢ and their combina-tion for CIAKI.Results Fasting blood glucose,TG,Cys C,and diuretics were independent risk factors(OR=1.116,95％CI:1.009-1.235;OR=1.786,95％CI:1.363-2.339;OR=13.360,95％CI:4.462-39.999;OR=10.606,95％CI:4.110-27.370),while LVEF and AT Ⅲ were protective factors(OR=0.932,95％CI:0.897-0.968;OR=0.949,95％CI:0.929-0.969)for CIAKI in eld-erly hypertensive patients after emergency PCI.The AUC value of Cys C and AT Ⅲ combined to-gether in predicting CIAKI after emergency PCI was 0.818(95％CI:0.773-0.863,P＜0.01),which was better than either of them alone.When Cys C level ≥1.10 mg/L,the risk of CIAKI was increased with the increment of the level;when AT Ⅲ ≥69％,the risk of CIAKI was decreased with the increase of AT Ⅲ level.Conclusion High Cys C level and low AT Ⅲ level are independ-ent risk factors for CIAKI,and their combination can improve the accuracy of predicting CIAKI after emergency PCI in elderly patients with hypertensive AMI.
