Abstract
Background The aim of the present study was to investigate the association between fibrinogen-to-albumin ratio (FAR) with contrast-induced nephropathy (CIN) in patients undergoing emergency percutaneous coronary intervention (PCI). Methods 565 patients with emergency PCI were consecutively enrolled. The primary outcome was CIN defined as either a 25% increase in baseline serum creatinine levels or a 0.5 mg/dL (44 μmol/L) increase in absolute serum creatinine levels within 72 h after the contrast medium exposure. Logistic regression analysis was applied to analyze whether FAR was an independent risk factor for CIN. Results Overall, 29 (5.1%) patients developed CIN. Compared with the patients without CIN, the patients developing CIN had lower albumin (39.79 ± 3.95 vs. 37.14 ± 5.21, P=0.012) and higher fibrinogen levels (3.51 ± 0.94 vs. 4.14 ± 0.96, P < 0.001). In the multivariate logistic analysis, FAR was an independent predictor of CIN (OR = 3.97; 95% CI, 1.61–9.80; P=0.003) along with perihypotension, age >75 years, and LVEF <45%, and 0.106 was the optimal cutoff value of preprocedural FAR to predict CIN. Conclusion Preprocedural levels of FAR were associated with CIN in patients after emergency PCI.
Highlights
Contrast-induced nephropathy (CIN) has become more frequent with the increased use of contrast media (CM), accounting for the third most common cause of hospitalacquired acute kidney injury (AKI) [1, 2]
Several studies have confirmed that inflammation plays an important role in the initiation and procession of CIN [8, 9]. e systemic inflammation response-based indexes, such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), have been introduced as indicators of CIN in ST-elevated myocardial infarction (STEMI), non-ST-elevated myocardial infarction (NSTEMI), and coronary artery bypass graft (CABG) [10,11,12,13,14]
Patients diagnosed with STEMI, or presented as high risk in those with non-ST-segment elevation acute coronary syndromes, were selected for this study. e exclusion criteria included: (1) patients with pregnancy, lactation, and malignant tumor; (2) end-stage renal disease (estimated glomerular filtration rate
Summary
Contrast-induced nephropathy (CIN) has become more frequent with the increased use of contrast media (CM), accounting for the third most common cause of hospitalacquired acute kidney injury (AKI) [1, 2]. CIN is associated with more in-hospital events, longer hospital stay, and increased risk of mortality, especially among patients undergoing emergency or primary percutaneous coronary intervention (PCI) [3,4,5]. E risk of CIN after emergency PCI is significantly increased than after elective PCI [6, 7]. Several studies have confirmed that inflammation plays an important role in the initiation and procession of CIN [8, 9]. To our knowledge, no studies have explored the association of FAR with CIN and long-term outcomes in patients with emergency PCI. E aim of this study was to investigate the role of FAR in predicting CIN and long-term outcome in patients undergoing emergency PCI
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