Predictive model for contrast-induced acute kidney injury after PCI in patients with acute myocardial infarction
10.3969/j.issn.1008-0074.2025.05.04
- VernacularTitle:急性心肌梗死患者PCI术后对比剂急性肾损伤的预测模型
- Author:
Yu YAN
1
;
Qi-bo SHUAI
1
;
Ting LI
1
Author Information
1. 哈尔滨医科大学附属第二医院心内科重症监护室,黑龙江哈尔滨 150081
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Acute kidney injury;
Angioplasty,balloon,coronary
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2025;34(5):611-617
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a model for predicting the occurrence of contrast-induced acute kidney injury(CI-AKI)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Meth-ods:A total of 767 AMI patients who underwent PCI in the Second Affiliated Hospital of Harbin Medical University between January 2019 and December 2023 were retrospectively included.According to presence of CI-AKI,pa-tients were divided into CI-AKI group(n=62)and non-CI-AKI group(n=705).The risk factors of CI-AKI in AMI patients undergoing PCI were analyzed using multivariant Logistic regression,and a prediction model was es-tablished.The model was evaluated using receiver operating characteristic(ROC)curve,calibration curve and clini-cal decision curve analysis(DCA).Results:Multivariant Logistic regression analysis showed that extensive anterior wall myocardial infarction(OR=1.520,95％CI:1.140～2.028,P=0.004),Killip class≥Ⅲ(OR=1.982,95％CI:1.406～2.793,P＜0.001),chronic renal insufficiency(OR=1.397,95％CI:1.025-1.903,P=0.034),ACEF(age,creatinine,ejection fraction)score(OR=1.702,95％CI:1.246～2.327,P＜0.001)and systemic im-mune-inflammation index(SII,OR=1.419,95％CI:1.090～1.847,P=0.009)were independent risk factors for CI-AKI after PCI in AMI patients.A prediction model of CI-AKI after PCI in AMI patients was established:Logit(P)=-1.667+0.334 ×(chronic renal insufficiency)+0.419 ×(extensive anterior wall myocardial infarc-tion)+0.684 ×(Killip class ≥Ⅲ)+0.350 × SII+0.532 ×(ACEF score).The ROC curve showed that the AUC of the model predicting CI-AKI was 0.868(95％CI:0.823-0.912,P＜0.001).The calibration curve showed a good fit of the predicted results to the actual curves(x2=0.421,P=0.506),and DCA showed net benefit when the high-risk threshold was between 5％and 70％.Conclusion:The prediction model for CI-AKI after PCI in AMI patients included extensive anterior wall myocardial infarction,Killip class,chronic renal insufficiency,ACEF score and SII,which had a good predictive performance for CI-AKI.
