Objective To explore the correlation between remnant cholesterol level and CI-AKI in elderly patients with ACS and concomitant T2DM following PCI.Methods A retrospective case-control study was conducted on 759 elderly T2DM patients with ACS undergoing PCI in the Affi-liated Hospital of Xuzhou Medical University between January 2020 and December 2023.The pa-tients were randomly allocated into a training group(n=608)and a validation group(n=151)in a ratio of 8∶2.Based on CI-AKI diagnostic criteria,the training group was further stratified into a CI-AKI subgroup(n=95)and a non-CI-AKI subgroup(n=513).Multivariate logistic regression analysis was used to identify the independent risk factors for CI-AKI.Results The remnant cho-lesterol level was significantly higher in the CI-AKI subgroup than the non-CI-AKI subgroup[0.78(0.51,1.07)mmol/L vs 0.57(0.40,0.81)mmol/L,P＜0.01].Red blood cell count,remnant cholesterol,age,uric acid,log-transformed systemic immune-inflammatory(SII)index,and cysta-tin C were identified as independent predictors for CI-AKI in T2DM patients with ACS after PCI(P＜0.01).ROC curve analysis demonstrated that the model combining remnant cholesterol with other independent predictors exhibited superior discriminative performance in both the training group(AUC=0.818,95％CI:0.773-0.863)and validation group(AUC=0.787,95％CI:0.686-0.889)when compared to the models excluding remnant cholesterol(P＜0.01).Conclusion Rem-nant cholesterol is an independent predictor of CI-AKI in elderly patients with ACS and T2DM af-ter PCI.A risk prediction model based on remnant cholesterol and other independent risk factors demonstrates enhanced predictive performance for postoperative CI-AKI in the patients.

Objective To investigate the predictive value of the atherogenic index of plasma(AIP)and systemic inflammatory re-sponse index(SIRI)for contrast-induced acute kidney injury(CI-AKI)in patients with hypertension complicated by acute ST-seg-ment elevation myocardial infarction(STEMI)undergoing emergency percutaneous coronary intervention(PCI).Methods A total of 964hypertensive patients with acute STEMI who underwent PCI treatment at the Affiliated Hospital of Xuzhou Medical University from Jan-uary 2021 to April 2025 were retrospectively enrolled.Using a randomized grouping method,the sample was divided into the training group(n=771)and the validation group(n=193)in a ratio of 8∶2.According to the diagnostic criteria for CI-AKI,the training group was further divided into the CI-AKI group(n=151)and the non-CI-AKI group(n=620),with baseline characteristics compared between the two groups.Multivariate Logistic regression models were constructed to identify independent predictors of postoperative CI-AKI,followed by receiver operating characteristic(ROC)curve analysis to evaluate the predictive efficacy of AIP,SIRI,and their combined detection for CI-AKI occurrence after PCI treatment.Results Left ventricular ejection fraction(LVEF),urea metabolism level,high-density lipoprotein cholesterol(HDL-C),diuretics,SIRI,and AIP showed significant correlations with the occurrence of CI-AKI in hypertensive patients with acute STEMI after PCI(P＜0.05).Multivariate Logistic regression analysis revealed that SIRI(OR=1.148,95％CI:1.060-1.244)and AIP(OR=5.946,95％CI:3.250-10.879)were independent risk factors for CI-AKI.The results of ROC curve analysis demonstrated that the combined detection of SIRI and AIP yielded an area under the curve of 0.805(95％CI:0.774-0.835),with the sensitivity of 70.8％and the specificity of 75.0％,which was significantly better than that of indi-vidual indicators(P＜0.001).The results of restricted cubic spline(RCS)indicated that when SIRI ≥ 2.773 or AIP ≥2.089,the risk of CI-AKI increased with rising levels of SIRI and AIP.Conclusion AIP and SIRI are independent risk factors for CI-AKI in hyperten-sive patients with acute STEMI after PCI,and their combined detection can improve the predictive efficacy of CI-AKI in hypertensive pa-tients with acute STEMI following PCI.

Objective To investigate the predictive value of the atherogenic index of plasma(AIP)and systemic inflammatory re-sponse index(SIRI)for contrast-induced acute kidney injury(CI-AKI)in patients with hypertension complicated by acute ST-seg-ment elevation myocardial infarction(STEMI)undergoing emergency percutaneous coronary intervention(PCI).Methods A total of 964hypertensive patients with acute STEMI who underwent PCI treatment at the Affiliated Hospital of Xuzhou Medical University from Jan-uary 2021 to April 2025 were retrospectively enrolled.Using a randomized grouping method,the sample was divided into the training group(n=771)and the validation group(n=193)in a ratio of 8∶2.According to the diagnostic criteria for CI-AKI,the training group was further divided into the CI-AKI group(n=151)and the non-CI-AKI group(n=620),with baseline characteristics compared between the two groups.Multivariate Logistic regression models were constructed to identify independent predictors of postoperative CI-AKI,followed by receiver operating characteristic(ROC)curve analysis to evaluate the predictive efficacy of AIP,SIRI,and their combined detection for CI-AKI occurrence after PCI treatment.Results Left ventricular ejection fraction(LVEF),urea metabolism level,high-density lipoprotein cholesterol(HDL-C),diuretics,SIRI,and AIP showed significant correlations with the occurrence of CI-AKI in hypertensive patients with acute STEMI after PCI(P＜0.05).Multivariate Logistic regression analysis revealed that SIRI(OR=1.148,95％CI:1.060-1.244)and AIP(OR=5.946,95％CI:3.250-10.879)were independent risk factors for CI-AKI.The results of ROC curve analysis demonstrated that the combined detection of SIRI and AIP yielded an area under the curve of 0.805(95％CI:0.774-0.835),with the sensitivity of 70.8％and the specificity of 75.0％,which was significantly better than that of indi-vidual indicators(P＜0.001).The results of restricted cubic spline(RCS)indicated that when SIRI ≥ 2.773 or AIP ≥2.089,the risk of CI-AKI increased with rising levels of SIRI and AIP.Conclusion AIP and SIRI are independent risk factors for CI-AKI in hyperten-sive patients with acute STEMI after PCI,and their combined detection can improve the predictive efficacy of CI-AKI in hypertensive pa-tients with acute STEMI following PCI.

Objective To explore the correlation between remnant cholesterol level and CI-AKI in elderly patients with ACS and concomitant T2DM following PCI.Methods A retrospective case-control study was conducted on 759 elderly T2DM patients with ACS undergoing PCI in the Affi-liated Hospital of Xuzhou Medical University between January 2020 and December 2023.The pa-tients were randomly allocated into a training group(n=608)and a validation group(n=151)in a ratio of 8∶2.Based on CI-AKI diagnostic criteria,the training group was further stratified into a CI-AKI subgroup(n=95)and a non-CI-AKI subgroup(n=513).Multivariate logistic regression analysis was used to identify the independent risk factors for CI-AKI.Results The remnant cho-lesterol level was significantly higher in the CI-AKI subgroup than the non-CI-AKI subgroup[0.78(0.51,1.07)mmol/L vs 0.57(0.40,0.81)mmol/L,P＜0.01].Red blood cell count,remnant cholesterol,age,uric acid,log-transformed systemic immune-inflammatory(SII)index,and cysta-tin C were identified as independent predictors for CI-AKI in T2DM patients with ACS after PCI(P＜0.01).ROC curve analysis demonstrated that the model combining remnant cholesterol with other independent predictors exhibited superior discriminative performance in both the training group(AUC=0.818,95％CI:0.773-0.863)and validation group(AUC=0.787,95％CI:0.686-0.889)when compared to the models excluding remnant cholesterol(P＜0.01).Conclusion Rem-nant cholesterol is an independent predictor of CI-AKI in elderly patients with ACS and T2DM af-ter PCI.A risk prediction model based on remnant cholesterol and other independent risk factors demonstrates enhanced predictive performance for postoperative CI-AKI in the patients.