Development and Validation of Nomogram to Predict Acute Kidney Injury in Patients with Acute Myocardial Infarction Treated Invasively

Abstract

To identify patients who are likely to develop contrast-induced acute kidney injury (CI-AKI) in patients with acute myocardial infarction (AMI), a nomogram was developed in AMI patients. Totally 920 patients with AMI were enrolled in our study. The discrimination and calibration of the model were validated. External validations were also carried out in a cohort of 386 AMI patients. Our results showed in the 920 eligible AMI patients, 114 patients (21.3%) developed CI-AKI in the derivation group (n = 534), while in the validation set (n = 386), 50 patients (13%) developed CI-AKI. CI-AKI model included the following six predictors: hemoglobin, contrast volume >100 ml, hypotension before procedure, eGFR, log BNP, and age. The area under the curve (AUC) was 0.775 (95% confidence interval [CI]: 0.732–0.819) in the derivation group and 0.715 (95% CI: 0.631–0.799) in the validation group. The Hosmer-Lemeshow test has a p value of 0.557, which confirms the model’s goodness of fit. The AUC of the Mehran risk score was 0.556 (95% CI: 0.498–0.615) in the derivation group. The validated nomogram provided a useful predictive value for CI-AKI in patients with AMI.