Association of transglutaminase-2 with contrast-induced acute kidney injury in Chinese patients with acute coronary syndrome: a prospective cohort study

BACKGROUND: To investigate the dynamic changes in serum and urinary Transglutaminase-2 (TG2) levels in acute coronary syndrome (ACS) patients and their association with contrast-induced acute kidney injury (CI-AKI), thereby providing novel clinical evidence for risk prediction of CI-AKI. METHODS: This single-center prospective cohort study consecutively enrolled ACS patients hospitalized in the Zhongda Hospital Affiliated to Southeast University, who underwent coronary angiography (CAG) between December 2023 and December 2024. Serum and urinary TG2 levels were measured before and after CAG using enzyme-linked immunosorbent assay. Multivariable logistic regression was performed to identify independent risk factors for CI-AKI, and a predictive model was constructed. RESULTS: < 0.001). The logistic regression prediction model incorporating ΔsTG2, ΔuTG2, and other risk factors achieved area under the curve values of 0.870 (95% confidence interval [CI]: 0.818-0.921) in the training set and 0.818 (95% CI: 0.741-0.895) in the test set, indicating good predictive performance. CONCLUSION: In ACS patients undergoing CAG, elevated serum and urinary TG2 levels and greater peri-procedural changes in these levels are closely associated with the occurrence of CI-AKI. Detecting TG2 levels, particularly their dynamic changes, may serve as an effective biomarker for predicting the risk of CI-AKI.