The Association between Inflammatory Indicators and the Incidence of Contrast-Induced Acute Kidney Injury in Patients Undergoing Elective Percutaneous Coronary Angiogram

Abstract

Background: Previous studies have shown that high-sensitivity C-reactive protein (hs-CRP) was an independent risk factor for Contrast-Induced Acute Kidney Injury (CI-AKI). However, the relationship between new inflammatory indicators (eg. NLR, Neutrophil to Lymphocyte Ratio; MLR, Monocyte to Lymphocyte Ratio; PLR, Platelets to Lymphocyte Ratio) and CI-AKI remains unclear. Methods: It was a multicenter retrospective observational study. Patients undergoing elective percutaneous coronary angiogram with creatinine record pre- and post-operative in 72hrs were recruited into this study from January 2015 to December 2019. All patients were divided into CI-AKI and non-CI-AKI groups. Multivariate logistic regression was used to explore the predictive value of inflammation indicators on CI-AKI. The receiver operating characteristic (ROC) curve was used, and the area under the ROC curve (AUC) were calculated. Results: Totally 3545 patients were enrolled, and 15.0% (532/3545) patients suffered from CI-AKI. Multivariate logistic regression analysis indicated that hs-CRP (OR 1.025, 95% CI 1.014-1.036, P<0.001) was an independent risk factor for the incidence of CI-AKI. NLR (OR 1.121, 95% CI 1.078-1.165, P<0.001), MLR (OR 5.672, 95% CI 3.400-9.463, P<0.001), PLR (OR1.043, 95% CI 1.024-1.062, P=0.001) were also independent risk factors for the incidence of CI-AKI. All the results were confirmed in the subgroup analysis, and the results were consistent. Conclusions: Elevated levels of inflammatory indicators, including hs-CRP, NLR, MLR, and PLR are independent risk factors for the incidence of CI-AKI in patients undergoing percutaneous coronary angiogram.