1.Diagnostic value of cystatin C in contrast-induced acute kidney injury after percutaneous coronary intervention
Li PENG ; Kanam WONG ; Songleong CHIO ; Kunchong TAM ; Waichun HUN ; Tao TAO ; Hong XIAO
Chinese Journal of Internal Medicine 2015;54(3):188-192
Objective To prospectively evaluate the value of cystatin C (CysC) in diagnosis of contrast-induced acute kidney injury (CIAKI) among patients undergoing Percutaneous Cardiovascular Intervention (PCI).Methods Patients who underwent PCI procedures in our hospital were enrolled.Serum creatinine(SCr) and CysC were measured at baseline before,24 h and 48 h after PCI,respectively.CysC were examined by particle-enhanced turbidimetric immunoassay (PETIA).CIAKI was defined as a relative increase in SCr concentration of at least 25% or an absolute increase more than 44.8 mmol/L (0.5 mg/dl) within 48 h in the absence of other related causes.Results Among 196 patients,135 were male and 61 female with a mean age of(70.4 ± 11.3)years old.Twenty-nine (14.8%)patients developed CIAKI according to the SCr criteria.The area under the ROC curve (AUC) at 24 h and 48 h post PCI were 0.661 (95% CI 0.548-0.774,P =0.006) and 0.783 (95% CI 0.701-0.865,P < 0.001),respectively.The diagnostic sensitivities of CysC at 24 h and 48 h were between 6.9% and 48.28%,while,the diagnostic specificities and negative predictive values of CysC were between 85.03%-97.60% and 85.79%-90.45%,respectively.The 15% elevation of 48 h CysC yielded the diagnostic sensitivity of 41.38%,specificity of 92.86%,negative predictive value of 90.17%,corrective rate of 85.28% with Youden Index of 0.342 4.Conclusions In this study,CysC presented an excellent diagnostic specificity and negative predictive value in diagnosis of CIAKI.It might be used as a tool for excluding CIAKI in clinical practice.48 h CysC performed better than 24 h CysC in CIAKI diagnosis,among which a 15% increment achieved relatively the best diagnostic value.