A comparison of on-admission blood cell count-derived parameters on the development of contrast-induced nephropathy in acute coronary syndromes

Abstract

Contrast-induced nephropathy (CIN) is a clinical entity closely associated with cardiac mortality and morbidity. We aimed to investigate the relationship between CIN after acute coronary syndrome and other bio-inflammatory parameters (Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio) as well as biomarkers such as AST/ALT, SIRI (Systemic Immnun Response Index), AISI (Aggregate Index of Systemic Inflammation), APRI (AST to platelet ratio index), SII (Systemic Immun Inflammation Index) NLR (Neutrophil to lymphocyte ratio), N/LPR (Neutrophil/ (lymphocyte x platelet), PLR (Platelet to lymphocyte ratio), MLR (Monocyte to lymphocyte ratio) and MPVLR (Mean platelet volume to lymphocyte ratio). In this retrospective cross-sectional study, we included 228 patients older than 18 years of age and underwent coronary angiography for acute coronary syndrome between January 2021 and May 2022. We applied the logistic regression analyzes to evaluate the relationship between patients' demographic, clinical characteristics, laboratory parameters, and contrast-induced nephropathy, and to evaluate the predictive power of the AST/ALT, AISI, SIRI, SII, NLR, PLR, MLR, N/LP ratio, MPVLR and other inflammatory based parameters on this primary endpoint. In the univariate analyses, prior history of coronary artery bypass, acute coronary syndrome type, prior ACEi/ARB usage, white blood cell count, hospitalization stay length, contrast amount, MLR, PLR, white blood cell to platelet ratio (WBCPR) were significantly associated with CIN. [p:0.039, p:0.017, p:0.025, p:0.044, p<0.001, p:0.003, p: 0.045, p: 0.044, p:0.044, respectively]. However, multivariable logistic regression analysis showed that WBCPR [OR 0.00 (95% CI 0.00- 0.01) p:0.005] and MLR [OR 13.522 (95% CI 2.15-84.72) p:0.005] might be statistically a significant independent predictor of CIN beside contrast amount [OR 1.92 (95% CI 01.23-3.02) p:0.004]. The WBCPR can be a new valuable independent predictor of CIN. Also, MLR and contrast amount may be a good independent predictor of CIN in acute coronary syndrome.