Contrast-induced nephropathy (CIN) remains a frequent and clinically relevant complication in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). This study evaluated the predictive performance of inflammation-based indices for CIN development, with a focus on the inflammatory prognostic index (IPI). STEMI patients (n = 563) were retrospectively analyzed. CIN developed in 85 patients (15.1%). Admission IPI values were significantly higher in patients who developed CIN compared with those without CIN (10.9 [7.6-16.2] vs 4.8 [3.1-7.9], P < .001). In multivariate logistic regression analysis, IPI remained independently associated with CIN (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.06-1.61, P = .013), together with advanced age, higher blood urea nitrogen levels, reduced left ventricular ejection fraction, history of stroke, and the occurrence of no-reflow. Receiver operating characteristic analysis demonstrated superior discriminative performance for IPI (area under the curve [AUC] 0.826, 95% CI 0.783-0.869) compared with neutrophil-to-lymphocyte ratio (NLR; AUC 0.691), C-reactive protein-to-albumin ratio (CAR; AUC 0.712), and systemic immune inflammation index (SII; AUC 0.704). An admission IPI cutoff value of 8.35 predicted CIN with 82.4% sensitivity and 65.9% specificity. IPI demonstrates superior discriminative performance compared with CAR, NLR, and SII for predicting CIN in STEMI patients undergoing pPCI.

AimTo assess the predictive value of serum lipoprotein(a) [Lp(a)] for contrast-induced nephropathy in patients with type 2 diabetes mellitus (T2DM).MethodsConsecutive T2DM patients who underwent coronary angiography (CAG) or percutaneous coronary intervention (PCI) between January 2019 and December 2021 were enrolled. Baseline Lp(a) was measured before the operation. CIN was defined as an increase in serum creatinine of more than 25% or 44 μmol within 72 h of contrast administration. The relationship between Lp(a) and CIN risk was analyzed.ResultsA total of 928 T2DM patients were included. CIN developed in 11.1% (103/928) of patients. The Lp(a) level was significantly higher in patients with CIN than in non-CIN patients (311.12 ± 278.66 vs. 254.19 ± 274.56 mg/L, P = 0.048). Patients were divided into three groups based on Lp(a) levels: <150 mg/L (n = 428), 150 mg/L–300 mg/L (n = 266), and ≥300 mg/L (n = 234). Each group stratified by increasing Lp(a) concentrations had incrementally greater risks of CIN (7.2% vs. 12% vs. 17.1%, P < 0.001). Multivariate logistic regression analysis showed that patients with Lp(a) ≥300 mg/L had a 2.41-fold higher risk of CIN than those with Lp(a)< 150 mg/L (OR = 2.41, 95% CI: 1.38–4.21, P = 0.002). Additionally, for each increase of 1 logarithmic unit in Lp(a), the risk of CIN increased by 1.27 times (OR = 1.27, 95% CI: 1.01–1.64, P = 0.045).ConclusionsA higher serum Lp(a) level indicates an increased risk of CIN in T2DM patients undergoing CAG or PCI and can serve as an independent predictor of CIN in this population. This study's findings will aid in the clinical prevention and treatment of contrast agent-induced kidney disease.

Background. As cardiac interventional medicine continues to advance, the occurrence of contrast-induced nephropathy (CIN) is on the rise each year. Trimetazidine, an anti-ischemic medication, has shown a noteworthy capability to reduce the occurrence of CIN. A systematic review and meta-analysis were carried out to assess trimetazidine’s clinical impact in preventing CIN in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI), regardless of the trimetazidine dose given. This meta-analysis aims to strengthen the latest data on the significance of administering a specific dose of oral trimetazidine (35 mg/tab twice daily for 72 hours) on elderly patients for prevention of CIN. Methods. A systematic review was conducted to find clinical trials that assess trimetazidine’s impact on the occurrence of CIN in elderly patients undergoing CAG/PCI up to January 2023. The search was carried out on databases including PubMed, Scopus, and Google Scholar. All were elderly patients (age &gt;50 years) given oral trimetazidine 35 mg/tab twice daily for 72 hours, and the outcome of interest was the occurrence of CIN, decrease in serum creatinine, and improvement in creatinine clearance. Results. The analysis of serum creatinine levels at various post-procedure time points revealed differing outcomes. At 24 hours post procedure, the trimetazidine group exhibited a significant average decrease of 0.09 mg/dL compared to control groups (95% CI -0.14, -0.03; p=0.003), with minimal heterogeneity. However, at 48 and 72 hours post procedure, the evidence was inconclusive, with varying levels of heterogeneity, suggesting result variability. A comprehensive analysis of all available studies indicated an average serum creatinine reduction of 0.13 mg/dL in the trimetazidine group, with statistical significance, although substantial heterogeneity was observed. Creatinine clearance at 72 hours post procedure showed an average increase in the trimetazidine group and minimal heterogeneity was present. An analysis of CIN rates across six studies demonstrated a risk ratio of 0.55, indicating a 45% reduction in CIN risk with trimetazidine, and a risk difference of 0.07, signifying 7 fewer expected CIN cases per 100 individuals treated with trimetazidine, with minimal heterogeneity observed in both analyses. Conclusion. Administering trimetazidine 35 mg/tab twice daily for 72 hours significantly decreases CIN risk in elderly patients undergoing CAG/PCI. Keywords. Trimetazidine, Contrast-induced nephropathy, Contrast-induced kidney injury

Contrast-induced nephropathy (CIN) is a common cause of acute renal failure. CIN is defined as an increase in serum creatinine (sCr) occurring after iodinated contrast agent (ICA) administration and is usually transient. When patients with mildly elevated baseline sCr levels are included, the risk of CIN in patients undergoing cardiac catheterization can be as high as 20%. To determine the role of glucose-to-lymphocyte ratio (GLR) in predicting the risk of developing CIN after coronary angiography (CAG). This is a retrospective study that included 929 patients who underwent CAG for non-ST elevation myocardial infarction (NSTEMI). The incidence of CIN was determined. GLR was calculated by dividing the blood glucose level by the lymphocyte count. CIN developed in 124 patients (13.3%) after the CAG procedure including percutaneous coronary intervention. CIN (+) patients were older than CIN (-) group (67.1 ± 10.8 vs. 62.4 ± 11.5, P = 0.046). The number of patients with diabetes mellitus was also higher in CIN (+) group (71 (57.3%) vs. 386 (48%), P < 0.001). Multivariate logistic regression analysis showed that GLR score (OR: 1.025, 95% confidence interval (CI): 1.0221-1.029, P < 0.001), serum glucose levels (OR: 1.011, 95% CI: 1.009-1.013, P < 0.001), white blood cell count (OR: 1.182, 95% CI: 1.101-1.268, P < 0.001), neutrophil-to-lymphocyte ratio score (OR: 1.12 95%CI: 1.077-1.167, P< 0.001) and platelet to lymphocyte ratio score (OR: 1.012, 95% CI: 1.009-1.015, P < 0.001) were independent predictors of the development of CIN. Receiver Operating Characteristic analysis, at a cut-off point of 104.39, GLR demonstrated 70% sensitivity and 82% specificity for detecting CIN. GLR value at admission was associated with the development of CIN after CAG in patients with NSTEMI.

This study aimed to evaluate the impact of contrast-induced nephropathy (CIN) on quality of life (QoL) in patients undergoing percutaneous coronary intervention (PCI) in Pakistan. A retrospective cohort study was conducted involving 5325 patients who underwent PCI, divided into CIN (n = 1250) and non-CIN (n = 4075) groups. Demographics, clinical characteristics, and procedural details were recorded. QoL was assessed using a standardized questionnaire before and after PCI, covering physical functioning, pain, mobility, anxiety/depression, and overall health. Statistical analyses compared QoL scores between groups and identified predictors of change. Patients who developed CIN exhibited a significant decline in post-PCI QoL across all domains compared to the non-CIN group (p < 0.05). CIN, older age, diabetes, lack of hydration protocol use, prolonged hospital stay, and lower baseline QoL were independent predictors of poorer QoL outcomes. Comorbidities were more prevalent in the CIN group, including diabetes (64.0 % vs. 47.8 %), hypertension (68.0 % vs. 60.8 %), and CKD Stage 3 or worse (28.0 % vs. 8.6 %) (all p < 0.05). CIN patients more frequently underwent PCI for acute coronary syndrome, received higher contrast volumes, and had lower use of preventive measures. Post-PCI complications such as heart failure (36.0 %), dialysis requirement (32.0 %), and prolonged hospital stays (60.0 %) were significantly higher in CIN patients. CIN adversely affects QoL following PCI, particularly in high-risk patients. Preventive strategies and early intervention are essential to mitigate CIN-related complications and improve patient-centered outcomes. Further prospective, multi-center studies are warranted.

Background: Contrast-induced nephropathy (CIN) is an important cause of morbidity in patients with myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI). Although the current guidelines support a multivariable risk assessment, the specific role of systemic immune-inflammation index (SII) remains unclear. This study aims to assess the diagnostic accuracy of the SII in predicting CIN among MI patients undergoing PCI. Methods: Embase, Scopus, and PubMed were systematically searched from inception to April 2025 to identify studies assessing the accuracy of SII in predicting CIN in MI patients (STEMI and NSTEMI) undergoing PCI. Mean differences (MD) were pooled using the inverse variance method under a random-effects model and presented with MD and 95% confidence intervals (CIs) using R Studio. Area under the curve (AUC) was pooled using the same approach and reported with 95% CIs using Review Manager v5.4.1. Diagnostic test accuracy meta-analysis was performed using Meta-DiSc v2 to present pooled sensitivity and specificity. Results: Six studies including 2,659 NSTEMI patients (CIN=393; no CIN=2,266) and 2,714 STEMI patients (CIN=251; no CIN=2,443) were included. Patients with CIN showed significantly higher SII in NSTEMI (MD: 593.38; 95% CI: 321.55, 865.20; p&lt;0.01) and STEMI (MD: 768.12; 95% CI: 452.94, 1083.31; p&lt;0.01). The AUC of SII was significant for NSTEMI (AUC = 0.80; 95% CI: 0.77, 0.84; p&lt;0.00001) and STEMI (AUC = 0.73; 95% CI: 0.60, 0.85; p&lt;0.00001). Diagnostic test accuracy meta-analysis identified SII as a reliable predictor for NSTEMI (sensitivity 77%, 95% CI: 69, 82; specificity 72%, 95% CI: 70, 74) and STEMI (sensitivity 78%, 95% CI: 72, 83; specificity 83%, 95% CI: 76, 88). Conclusion: The SII is a reliable biomarker for predicting CIN in NSTEMI and STEMI patients, showing significant diagnostic accuracy. Integrating SII into existing risk models can improve early risk stratification and guide preventive measures. Future research should validate optimal SII thresholds, explore its dynamic changes around contrast exposure, and evaluate combined use with other biomarkers to enhance personalized CIN risk prediction and management in line with current cardiology guidelines.

Introduction: Contrast-induced nephropathy (CIN) is a significant complication following the use of iodinated contrast agents during cardiac procedures. Cardiac resynchronization therapy (CRT), increasingly used in heart failure management, requires contrast administration, putting patients at risk for CIN. However, the prevalence and outcomes of CIN in CRT recipients remain underexplored.Methods: We conducted a retrospective cohort study using the Nationwide Readmissions Database (NRD) from 2016 to 2020. Adult patients undergoing CRT or CRT-D implantation were identified using International Classification of Diseases, 10th edition (ICD-10) codes. The primary outcome was the annual prevalence of CIN. Secondary outcomes included 30-day hospital readmission, mortality, metabolic acidosis, hyperkalemia, and continuous renal replacement therapy (CRRT). Multivariable logistic regression assessed temporal trends, adjusting for patient demographics and comorbidities.Results: Among 42,545 patients undergoing CRT, CIN prevalence increased from 20.61% in 2016 to 26.40% in 2020 (p < 0.001). CIN was associated with significantly higher 30-day readmission rates, longer hospital stays (mean length of stay (LOS): 7.64 vs. 4.36 days in non-elective cases), and higher hospitalization costs. The incidence of metabolic acidosis rose from 13.73% to 18.51% (p < 0.001), and CRRT use increased from 3.30% to 5.11% (p = 0.03). While overall mortality was higher among CIN patients (2.84% vs. 0.53%), no significant trend in mortality was observed over time (p = 0.352).Conclusion: CIN is an increasingly prevalent complication in patients undergoing CRT and is associated with worse clinical outcomes and higher healthcare utilization. These findings underscore the need for implementing standardized nephroprotective strategies, including contrast minimization protocols and early risk stratification, to mitigate renal complications in this high-risk population.

Lower extremity peripheral artery disease (LEAD) is a disease that impairs quality of life, causes amputation and is associated with mortality. Percutaneous interventions are performed for therapeutic purposes in patients with LEAD. Contrast-induced nephropathy (CIN) may emerge due to the contrast media used during these interventions. This study aimed to investigate the predictive value of six scoring systems, including AGEF, ACEF, Zhi-Feng Yao, CR4EATME3AD3, Mehran, and Tziakas, for CIN. This retrospective study included 690 patients with LEAD. The study population was divided into two groups according to the presence of CIN. In our study, the AGEF, ACEF, Tziakas, Zhi-Feng Yao, CR4EATME3AD3, and Mehran scoring systems demonstrated robust predictive capabilities for the development of CIN following percutaneous intervention in patients with LEAD. Moreover, the AGEF, Zhi-Feng Yao, CR4EATME3AD3, and Mehran scores were identified as independent predictors of CIN development in patients with LEAD revascularized via endovascular interventions. The findings of this study revealed that various scoring systems performed well in predicting CIN in LEAD patients. In addition, among these scoring systems, AGEF has been shown to be the best in terms of predictive power.

Objectives: This study aims to investigate whether trimetazidine (TMZ) alone has a preventive effect on contrast-induced nephropathy (CIN) in patients with preserved kidney function who underwent angiographic procedures and the variables associated with CIN development. Patients and methods: Between June 2023 and September 2023, a total of 305 patients (199 males, 106 females; mean age: 60±10 years; range, 54 to 67 years) who underwent coronary angiographic procedures with diagnosed or suspected stable coronary artery disease and an estimated glomerular filtration rate (eGFR) of &gt;60 mL/min/1.73 m2 were included. A total of 153 patients received TMZ (TMZ group), while 152 patients were naïve to TMZ (non-TMZ group). Results: Ten patients (6.5%) in the non-TMZ group and nine patients (5.8%) in the TMZ group developed CIN within 48 to 72 h (p=0.801) after the procedures. The mean serum creatinine level increased from 0.84±0.1 mg/dL to 0.89±0.2 mg/dL in the non-TMZ group (p&lt;0.001) and from 0.84±0.1 mg/dL to 0.88±0.2 mg/dL in the TMZ group (p=0.008). Multivariate logistic regression analysis revealed that only age (odds ratio [OR]: 1.10, 95% CI: 1.03-1.18, p=0.003) was an independent predictor of CIN. A cut-off value of 60 years (area under the curve [AUC]=0.785; sensitivity, 100%; specificity, 52%) predicted CIN development in the non-TMZ group, whereas it was 72.5 years (AUC=0.711; sensitivity, 55%; specificity, 90%) for the TMZ group. Conclusion: Our study results suggest that the use of TMZ may be beneficial on CIN in elderly patients undergoing coronary angiographic procedures, even if the eGFR is ≥60 mL/min/1.73 m2.

Abstract Background and Aims Contrast-induced nephropathy (CIN) is a complication that causes significant morbidity and mortality in patients with acute coronary syndrome (ACS), even after successful percutaneous coronary intervention (PCI). Early identification of high-risk patients is crucial for prognosis. In this study, we aimed to investigate the predictive value of the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) score, an alternative thromboembolism risk scoring model, in the development of CIN in patients with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing PCI, independent of atrial fibrillation. Method This retrospective study included patients hospitalized in the coronary intensive care unit between 2017 and 2023 with a diagnosis of NSTEMI and treated with PCI. Patients were divided into two groups based on the development of CIN, and their clinical, demographic, and laboratory findings were statistically compared. The ATRIA and CHA2DS2-VASc scores of the patients were calculated. Results A total of 550 patients who underwent PCI due to NSTEMI were included in the study. CIN was observed in 78 patients (14.1%) following PCI. While no difference was found between the groups in terms of gender, the mean age of patients who developed CIN was significantly higher at 67.1 ± 10.8 years compared to those without CIN (P &amp;lt; 0.001). The rates of diabetes, heart failure, and prior stroke were higher in the CIN group. The ejection fraction assessed via transthoracic echocardiography was significantly lower in the CIN group (43.4 ± 12.5%) compared to the non-CIN group (52.2 ± 10.6%) (P &amp;lt; 0.001). The volume of contrast media used during PCI was similar between the groups (P = 0.538). CHA2DS2-VASc and ATRIA scores were significantly higher in patients who developed CIN compared to those who did not (4.31 ± 1.52 vs. 2.23 ± 1.34, P &amp;lt; 0.001; 4.25 ± 2.55 vs. 3.26 ± 2.68, P &amp;lt; 0.001). Conclusion We demonstrated that a high ATRIA score has predictive value for the development of CIN in NSTEMI patients undergoing PCI. Additionally, the CHA2DS2-VASc score, previously shown to be associated with CIN in ACS patients, was also found to provide supplementary information for predicting the incidence of CIN in our study.

Contrast-induced nephropathy (CIN) remains a significant complication following coronary angiography (CAG) and percutaneous coronary intervention (PCI), particularly among patients with diabetes mellitus. Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) have demonstrated renoprotective effects in chronic kidney disease; however, their role in preventing CIN remains unclear. In this retrospective, single-center study, 206 patients with diabetes mellitus and acute coronary syndrome (ACS) undergoing CAG or PCI were included. Patients were divided into two groups based on SGLT-2i usage. Lasso penalized regression analysis was performed to identify significant predictors of CIN, followed by multivariate logistic regression analysis to adjust for potential confounders. The predictive performance of the model was assessed using a receiver-operating characteristic curve. The study included 94 SGLT-2i users and 112 nonusers. CIN occurred less frequently among SGLT-2i users (9.6 vs. 16.1%). Lasso regression identified female sex, SGLT-2i usage, contrast amount, baseline glomerular filtration rate (GFR), and left ventricular ejection fraction (LVEF) as significant predictors of CIN. Multivariate analysis demonstrated that SGLT-2i usage was independently associated with a reduced risk of CIN (odds ratio: 0.24, P = 0.012), while female sex, lower LVEF, worse baseline GFR, and higher contrast volume were associated with increased CIN risk. The final model exhibited excellent discriminative ability (area under the curve: 0.85). SGLT-2i usage was independently associated with a decreased risk of CIN among diabetic patients with ACS undergoing coronary interventional procedures. Female sex, reduced LVEF, impaired renal function, and greater contrast volume emerged as independent predictors of increased CIN risk.

Contrast-induced nephropathy (CIN) is an iatrogenic impairment to the kidneys that can occur in susceptible persons after intravascular injections of contrast agents. Individuals undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) often bear the risk of developing CIN. The likelihood of CIN can be predicted using several techniques, although none of them are very accurate. CHA2DS2-VASc score is used to predict unfavorable clinical outcomes in patients with ACS and atrial fibrillation. The score comprises preprocedural variables and is simple to calculate and can be used for predicting CIN. This study aims to validate CHA2DS2-VASc score to predict occurrence of CIN among patients undergoing PCI. This cross-sectional research has been carried out at a tertiary care hospital. The study comprised a total of 182 patients who were admitted with ACS and underwent PCI. CIN incidence was computed. The study population was divided into two groups (the CIN group and the non-CIN group) based on the incidence of CIN. The CHA2DS2-VASc score was computed for every patient. The best cutoff values of the CHA2DS2-VASc score to predict the development of CIN were found using receiver operating characteristic (ROC) curve analysis. The incidence of CIN was computed both above and below the CHA2DS2-VASc score's optimal cutoff point. The incidence of CIN among patients undergoing PCI was 14.3%, and the ROC value for the CHA2DS2-VASc score was 0.896. Statistically significant increases in the incidence of CIN were observed in patients undergoing PCI who had a CHA2DS2-VASc score of >2. Additionally, a significant relationship was discovered between CIN and age, diabetes, hypertension, prior coronary artery disease (CAD), and Killip class ≥2. Patients with CHA2DS2-VASc score of >2 had higher incidence of CIN. CHA2DS2-VASc score was found to be useful in predicting contrast nephropathy among patients with acute myocardial infarction undergoing angiography.

Background and Aim: Contrast-induced nephropathy (CIN) is a serious complication of coronary angiography (CA), associated with increased morbidity and mortality.Coenzyme Q10 (CoQ10), an endogenous antioxidant, has shown promise in mitigating oxidative renal injury.This study investigated CoQ10's protective effect against CIN in acute coronary syndrome (ACS) cases undergoing CA. Materials and Methods:In a prospective randomized clinical trial (registration number: NCT06429345, date: 19.03.2024), 300 ACS cases were enrolled between March and September 2024.Cases were randomized into a CoQ10 group (n=200) receiving oral CoQ10 and a control group (n=100) receiving standard care.Serum creatinine, estimated glomerular filtration rate (eGFR), and urine output were monitored for three days post-procedure.CIN was defined as a 0.5 mg/dL or 25% increase in serum creatinine or a 25% decline in eGFR within 48 hours.Results: CIN incidence was significantly lower in the CoQ10 group (9%) compared to controls (21%) (P = 0.004).Postoperative serum creatinine levels were markedly lower, and eGFR notably higher, in the CoQ10 group on days two and three (P < 0.01).Multivariate logistic regression identified high body mass index [odds ratio (OR) =6.976, P < 0.001], chronic kidney disease (OR =6.288, P = 0.001), and balloon dilatation (OR =3.116, P = 0.012) as independent predictors of CIN. Conclusion:CoQ10 supplementation significantly reduced CIN incidence in ACS cases undergoing CA.CoQ10's antioxidative and antiinflammatory properties support its potential as a safe adjunctive therapy for CIN prevention.

Background:Contrast-induced nephropathy (CIN) remains a significant complication in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI).Methods:A comprehensive literature search was conducted across PubMed, MEDLINE, Embase, Google Scholar, and Web of Science up to May 2024 to identify randomized controlled trials (RCTs) evaluating the efficacy and safety of nicorandil in patients undergoing CAG or PCI. The primary outcome was CIN incidence, while secondary outcomes included, changes in serum creatinine, serum cystatin C, blood urea nitrogen (BUN), and estimated glomerular filtration rate (eGFR). Risk ratios (RRs) and standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed using the I2 statistic.Results:Eleven RCTs and one prospective cohort study involving 2910 patients were included. Nicorandil administration was associated with a significant reduction in CIN incidence (RR: 0.40 [0.31–0.52], P < 0.00001), with both oral (RR: 0.35 [0.25–0.48], P < 0.00001) and intravenous formulations (RR: 0.52 [0.30–0.92], P = 0.02) demonstrating efficacy (p-interaction = 0.22). Patients receiving nicorandil exhibited significantly lower serum creatinine levels at 48 hours (SMD: −0.34 [–0.52, −0.16], P = 0.0002) and 72 hours (SMD: −0.24 [–0.40, −0.08], P = 0.003) post-procedure. Serum cystatin C was also significantly reduced at 48 hours (SMD: −0.48 [–0.81, −0.15], P = 0.004). However, nicorandil did not produce a significant change in eGFR at 24 hours (SMD: 0.17 [–0.07, 0.41], P = 0.17), 48 hours (SMD: 0.13 [–0.10, 0.37], P = 0.26), or 72 hours (SMD: 0.19 [–0.07, 0.45], P = 0.36).Conclusion:Nicorandil administration reduces CIN incidence and improves renal biomarker profiles in patients undergoing CAG and PCI. Further large-scale trials are necessary to validate its renoprotective properties.

The Predictive Value of the CHA2DS2-VASc Score in the Development of Contrast-Induced Nephropathy after Endovascular Intervention in Peripheral Artery Disease.

Triglyceride glucose-body mass index (TyG-BMI) is an indicator of insulin resistance (IR) and is associated with an increased risk of adverse cardiovascular events. Insulin resistance (IR) is an important pathogenesis of diabetes mellitus, and also an important factor affecting the incidence and prognosis of cardiovascular diseases. However, the relationship between TyG-BMI and CIN in patients with STEMI has not been studied. STEMI patients who underwent percutaneous coronary intervention (PCI) between January 2017 and July 2020 were selected consecutively. The occurrence of contrast-induced nephropathy (CIN) is determined by the serum creatinine concentration. A total of 1041 patients (813; 78.1% male) with STEMI who underwent primary PCI were enrolled in this retrospective study. The registered cohort was divided into 2 groups according to whether the subjects developed CIN after surgery. CIN was defined as an increase in serum creatinine > 25% or 0.5 mg/dL from baseline in the first 48 to 72 h after PCI. A total of 201 cases (19.3%) of CIN were diagnosed. Compared with CIN (−) patients, CIN (+) patients had larger BMI, higher proportion of hypertension and hyperlipidemia, higher levels of fasting blood glucose, total cholesterol, triglyceride and uric acid, and higher levels of metabolic score for insulin resistance (METS-IR), triglyceride-glucose index (TyG) and TyG-BMI. Multivariate logistic regression analysis showed that TyG-BMI (OR = 1.029,95%CI 1.011–1.047, P = 0.002) were the independent risk factors for CIN in STEMI patients after primary PCI. ROC curve analysis showed that TyG-BMI had a high predictive value for CIN (AUC = 0.812; 95%CI 0.784–0.840), the best cut-off value was 196.34, the sensitivity was 85.6%, and the specificity was 73.1%. TyG-BMI is an independent risk factor for CIN after pPCI in STEMI patients and has a good predictive effect for the occurrence of CIN after pPCI.

Background/Objectives: Contrast agents can damage renal tissue through multiple mechanisms, particularly by increasing reactive oxygen species (ROS), which contribute to DNA oxidation, lipid peroxidation, and endothelial injury. This prospective, comparative study aimed to evaluate the changes in ROS-related gene expressions-NFKB1, SIRT1, NFE2L2, and FOXO1-in patients who developed contrast-induced nephropathy (CIN) following coronary angiography versus those who did not. Methods: A total of 48 patients undergoing primary percutaneous coronary intervention were enrolled. Twenty-three patients who developed CIN (Group 1) were compared to 25 matched controls without CIN (Group 2) based on age, gender, and comorbidities. Blood and serum samples were collected 72 h post-contrast exposure to assess biochemical markers and mRNA expression levels of the target genes. Results: The mean age was similar between the groups (63 ± 7 vs. 62 ± 6 years; p > 0.05), as was gender distribution. Group 1 showed significant increases in serum creatinine and reductions in e-GFR post-procedure. Importantly, NFKB1, NFE2L2, and FOXO1 mRNA expression levels were significantly upregulated in CIN patients-by 5.7-, 5.8-, and 4.97-fold, respectively, while SIRT1 expression was downregulated by 0.76-fold (p < 0.05). Conclusions: These findings indicate enhanced activation of inflammatory and oxidative stress pathways in CIN patients, particularly through the NF-κB signaling axis. Conversely, reduced SIRT1 expression suggests diminished antioxidant protection. The study highlights that ROS-related gene expression changes may serve as potential biomarkers for CIN progression. Further studies at the protein level are needed to clarify cytokine roles in these pathways.

Background and aims: Contrast-induced nephropathy (CIN) is a common and serious complication related to the intravenous injection of iodinated contrast media. Thus, the aim of this study was to evaluate CIN frequency and the relationship of some variables with CIN in patients who were referred to Hajar hospital, Shahrekord, Iran. Methods: The study was performed on 200 patients who were candidates for contrast-enhanced computed tomography with intravenous contrast in Shahrekord, Iran, in 2018. Metformin and non-steroid anti-inflammatory drugs were discontinued from 48 hours before to 48 hours after the contrast prescription. Almost 100 mL of nonionic, iso-osmolar contrast media (Visipaque or Dixopaque) were used for patients. After 48 hours of contrast injection, blood urea nitrogen and serum creatinine (Cr) were checked, and the related data were collected. Cr rising&gt;0.3 mg/dL of baseline and Cr rising&gt;0.5 mg/dL were considered acute kidney injury (AKI) and CIN, respectively. Results: The mean age of patients was 63.65±20 years. In addition, the mean serum Cr of patients before and after the contrast injection was 1.13±0.83 mg/dL and 1.10±0.72 mg/dL, respectively (P=0.44). The frequency of AKI nephropathy (serum Cr rising&gt;0.3 mg/dL) was 11.5% (n=23). However, with a 0.5 mg/dL increase in serum Cr, it was 4.5% (n=9). Only the age of patients was found to be a risk factor for CIN. Conclusion: CIN was not common in cases with normal or near-normal renal function. However, contrast prescription should be performed more carefully in old age patients.

Введение. Развитие острой почечной недостаточности вследствие конт раст-индуцированной нефропатии, является фактором, ухудшающим общий прогноз и требующим своевременной коррекции модифицируе мых факторов риска и проведения превентивных мероприятий. Цель исследования. Изучить взаимосвязь показателей общего анализа крови с развитием контраст-индуцированной нефропатии у больных коронарной болезнью сердца после проведения эндоваскулярных вме шательств. Материалы и методы исследования. В исследование включено 184 па циента, проходивших стационарное лечение в клинических отделениях Национального центра кардиологии и терапии имени академика Мир саида Миррахимова при Министерстве здравоохранения Кыргызской Республики. Возраст больных колебался от 30 до 70 лет (средний воз раст составил 55,2±8,5 лет). Из числа обследованных мужчин было 132 (71,7%), а женщин – 52 (28,3%). Все пациенты страдали различными формами коронарной болезни сердца (КБС). Больным проводили об щеклиническое обследование, антропометрические и биохимические исследования, включающие определение общего анализа крови, а также электрокардиографию, эхокардиографию, ультразвуковой иссле дование почек и коронароангиографию (КАГ). Всем пациентам оце нивали риск развития контраст - индуцированной нефропатии (КИН) по шкале R. Mehran (2004). Результаты. У 32 (17,4%) из 184 пациентов, включенных в исследо вание, развилась КИН. Проведенный логистический регрессионный анализ показал, что к независимым факторам, ассоциированным с раз витием КИН у больных с эндоваскулярными вмешательствами, отно сятся: острый инфаркт миокарда - (ОР 3,98; 95% ДИ 1,05 - 16,6), сахарный диабет (ОР - 5,47; 95% ДИ 2,9 - 10,1) и увеличение количе ства лейкоцитов (ОР - 1,33; 95% ДИ 1,02 - 1,74). Заключение. Увеличение числа лейкоцитов является независимым фак тором риска развития контраст-индуцированной нефропатии у боль ных коронарной болезнью сердца после эндоваскулярного вмешательства. Introduction. The development of acute renal failure due to contrast-induced nephropathy is a factor that worsens the overall prognosis and requires timely correction of modifiable risk factors and preventive measures. Purpose of the study. To study the relationship between complete blood cell count parameters and the development of contrast-induced nephropathy in patients with coronary heart disease after endovascular interventions. Materials and research methods. The study included 184 patients who un derwent inpatient treatment in the clinical departments of the National сenter for сardiology and therapy named after academician Mirsaid Mirrakhimov under the Ministry of Health of the Kyrgyz Republic. The age of the patients ranged from 30 to 70 years (mean age was 55,2±8,5 years). Of the surveyed men, there were 132 (71,7%), and women - 52 (28,3%). All patients suffered from various forms of coronary heart disease. Patients underwent a general clinical examination, anthropometric and biochemical studies, including the determination of a diffuse complete blood count, as well as electrocardiog raphy, echocardiography, ultrasound examination of the kidneys and coro nary angiography. All patients were assessed for the risk of developing contrast-induced nephropathy according to the R. Mehran scale (2004). Results. 32 (17.4%) of 184 patients included in the study developed CIN. The performed logistic regression analysis showed that independent factors associated with the development of CIN in patients with endovascular in terventions include: acute myocardial infarction - (RR 3.98; 95% CI 1,05 - 16,6), diabetes mellitus (RR – 5,47; 95% CI 2,9 – 10,1) and an increase in the number of leukocytes (RR – 1,33; 95% CI 1.02 - 1.74). Conclusion. An increase in the number of leukocytes is an independent risk factor for the development of contrast-induced nephropathy in patients with coronary heart disease after endovascular intervention. Киришүү. Контрасттык нефропатия курч бөйрөк жетишсиздигинин улам өнүгүшүнө жалпы божомолду начарлатуучу фактор болуп саналат жана өзгөртүлүүчү тобокелдик факторлорун өз убагында оңдоону жана алдын алуу иш-чараларын жүргүзүүнү талап кылат. Изилдөөнүн максаты: эндоваскулярдык кийлигишүүлөрдү жүргүзгөн дөн кийин коронардык артерия оорусу менен ооруганбейтаптарда конт расттык нефропатиянын өнүгүшү менен жалпы кан анализинин көрсөт күчтөрүнүн байланышынын изилдөө. Материалдар жана ыкмалар. Илдөөгө Кыргыз Республикасынын Са ламаттык сактоо министрлигине караштуу академик Мирсаид Мирра химов атындагы Улуттук кардиология жана терапия борборунун клиникалык бөлүмдөрүндө стационардык дарылануудан өткөн 184 бейтап кирген. Оорулуулардын жаш курагы 30дан 70 жашка чейин (ор точо жашы 55,2 - 8,5 жашты түздү). Изилдөөгө алынган эркектердин саны 132 (71,7%), аялдар 52 (28,3%) болгон. Бардык бейтаптар коро нардык артерия оорусунун (КАС) ар кандай түрлөрүнөн жапа чеккен. Бейтаптардын баарына кандын жалпы анализин аныктоону камтыган антропометриялык жана биохимиялык изилдөөлөр, ошондой эле элек трокардиография, эхокардиография, бөйрөктү ультраүн изилдөө жана коронароангиография (КАГ) жүргүзүлгөн. Бардык бейтаптар контраст тык нефропатиянын өнүгүү коркунучуну Мехран шкаласы боюнча баа ланган (2004). Натыйжалар. Изилдөөгө катышкан 184 бейтаптын арасынан 32 бей тапта (17,4%) контрасттык нефропатия өнүккөн. Жүргүзүлгөн логисти калык регрессиялык талдоо көрсөткөндөй, эндоваскулярдык кийли гишүүдөн кийин КАО менен ооруган бейтаптарда контрасттык нефро патиянын өнүгүүсү менен байланышкан көз карандысыз факторлорго төмөнкүлөр кирет: курч миокард инфаркты - (ОР 3,98; 95% ДИ 1,05 - 16,6), кант диабети (ОР - 5,47; 95% ДИ 2,9 - 10,1) жана лейкоциттердин санынын көбөйүшү (ОР - 1,33; 95% ДИ 1,02 - 1,74). Жыйынтыгы. Лейкоциттердин көбөйүшү эндоваскулярдык кийлигишү үдөн кийин коронардык артерия оорусу менен оорулууларында контрасттык нефропатиянын өнүгүшү үчүн көз карандысыз тобокелдик фактору болуп саналат.

Contrast-induced nephropathy (CIN) is a feared complication of angiographic procedures, resulting in a sudden decline in renal function. PubMed, ScienceDirect, and Google Scholar were searched for potentially relevant articles from inception till August 2024. The meta-analysis was conducted using RevMan 5.4 with risk ratios (RR), mean differences (MD), and 95% confidence intervals (95% CI) computed. Ultimately, 13 studies were incorporated in the analysis. Nicorandil portrayed a significant protective effect against CIN (RR: 0.42; 95% CI: 0.33-0.54; p < 0.00001). Subgroup analysis revealed the superiority of the oral administration (RR: 0.38; 95% CI: 0.28-0.50; p < 0.00001). Nicorandil was also effective in reducing CIN in renal dysfunction patients (RR: 0.40; 95% CI: 0.27-0.59; p < 0.00001). Blood urea nitrogen (BUN) and cystatin-C 48-hours post-procedure (MD: -0.42; 95% CI: -0.53--0.30; p < 0.00001 and MD: -0.27; 95% CI: -0.51--0.02; p = 0.03, respectively) were superior in the nicorandil cohort. Serum creatinine was significantly lower in patients receiving nicorandil at 24- and 72-hour intervals (MD: -3.18, MD: -4.26, and MD: -3.75, respectively). There were no increased risks of adverse events in the nicorandil cohort. Nicorandil has promising efficacy and safety in reducing the risk of CIN. However, further trials are necessary in order to validate our conclusions.