Identification of Factors Associated With Contrast-Induced Nephropathy After PCI – The Cardiology Advisor

Higher mean platelet volume-to-lymphocyte ratio (MPVLR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were found to be associated with the development of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation acute coronary syndrome (ACS), according to a study published in Angiology.

In this retrospective study, we examined the data of patients who had undergone PCI and were diagnosed with STEMI ACS and non-STEMI ACS confirmed by coronary angiography (n=564; mean age, 62.3+13.0 years).

In this cohort, 62 patients developed CIN after PCI. Patients who developed vs patients who did not develop CIN were older (69.310.3 vs 53.112.3 years, respectively; P <.001) and had a higher prevalence of diabetes (46% vs 27%, respectively; P =.006), ower left ventricular ejection fraction (LVEF) percentages (44.27.3% vs 53.16.0%, respectively; P <.001), higher MPVLRs (4.560.67 vs 3.670.41, respectively; P <.001), higher NLRs (2.60.78 vs 2.10.41, respectively; P <.001), and higher PLRs (1626 vs 12855, respectively; P =.001).

Hemoglobin (odds ratio [OR], 0.937; 95% CI, 0.921-0.953; P =.009), lymphocyte count (OR, 0.314; 95% CI, 0.149-0.512; P <.001), MPVLR (OR, 1.533; 95% CI, 1.203-1.632; P <.001), age (OR, 1.004; 95% CI, 0.997-1.014; P <.001), sex (OR, 0.901; 95% CI, 0.735-1.103; P =.002), hypertension (OR, 1.120; 95% CI, 0.940-1.316; P =.003), LVEF (OR, 0.944; 95% CI, 0.910-0.987; P =.001), total amount of contrast media (OR, 0.971; 95% CI, 0.936-0.992; P =.001), and total duration of procedure (OR, 1.147; 95% CI, 1.04-1.281; P <.001) were all found to be independent predictors of CIN in a multivariable analysis.

Limitations of the study include its observational, retrospective, and single-center design, the small cohort, and the lack of participants with stable coronary disease.

The MPVLR, as the best marker in our study, may prove useful in predicting CIN, noted the study authors.

Reference

Zorlu C, Koseoglu C. Comparison of the relationship between inflammatory markers and contrast-induced nephropathy in patients with acute coronary syndrome after coronary angiography. Angiology. 2020;71(3):249-255.

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Identification of Factors Associated With Contrast-Induced Nephropathy After PCI - The Cardiology Advisor